| NPI | 1578005815 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: FL IMH20986) |
| Additional Taxonomies | 106S00000X Behavior Technician |
| Enumeration Date | 2016-11-16 |
| Last Update Date | 2021-09-09 |