| NPI | 1558903138 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: NC 17489) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: NC A17489) |
| 106S00000X Behavior Technician | |
| Enumeration Date | 2019-10-15 |
| Last Update Date | 2024-08-21 |