| NPI | 1568044550 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health |
| Additional Taxonomies | 106S00000X Behavior Technician (Licence: GA RBT-21-165829) |
| Enumeration Date | 2021-04-28 |
| Last Update Date | 2025-09-16 |