| NPI | 1548924996 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 106S00000X Behavior Technician (Licence: VA RBT21152347) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: VA 0733007985) |
| Enumeration Date | 2021-10-22 |
| Last Update Date | 2021-10-22 |