| NPI | 1548632425 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health |
| Additional Taxonomies | 103K00000X Behavior Analyst (Licence: PA BH002751) |
| 103K00000X Behavior Analyst (Licence: WV 1-15-20152) | |
| Enumeration Date | 2015-10-30 |
| Last Update Date | 2015-11-23 |