| NPI | 1548743701 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor Mental Health |
| Additional Taxonomies | 101YA0400X Counselor Addiction (Substance Use Disorder) |
| 103TB0200X Psychologist Cognitive & Behavioral | |
| 103TC1900X Psychologist Counseling | |
| 103TM1800X Psychologist Mental Retardation & Developmental Disabilities | |
| 103TS0200X Psychologist School | |
| 1041S0200X Social Worker School | |
| 106E00000X Assistant Behavior Analyst | |
| Enumeration Date | 2018-09-12 |
| Last Update Date | 2018-09-12 |