| NPI | 1558811919 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: WA MC61500263)  | 
| Additional Taxonomies | 106S00000X Behavior Technician (Licence: OR 10179508)  | 
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2016-10-10 | 
| Last Update Date | 2024-10-01 |