| NPI | 1558076208 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: NY P135831) |
| Additional Taxonomies | 106S00000X Behavior Technician |
| Enumeration Date | 2023-01-17 |
| Last Update Date | 2026-04-20 |