| NPI | 1548739774 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: FL IMH24325) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: CA APCC11755) |
| 106S00000X Behavior Technician (Licence: CA RBT-19-75915) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2018-11-16 |
| Last Update Date | 2023-09-19 |