NPI | 1558716332 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: FL MH23516) |
Additional Taxonomies | 106H00000X Marriage & Family Therapist |
106S00000X Behavior Technician (Licence: FL RBT-16-13915) | |
Enumeration Date | 2016-04-28 |
Last Update Date | 2024-04-06 |