| NPI | 1578066544 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker Clinical (Licence: MT BBH-LCSW-LIC-38882) |
| Additional Taxonomies | 101YP2500X Counselor Professional (Licence: MT BBH-LCPC-LIC-34703) |
| 103K00000X Behavior Analyst (Licence: MT 1-21-48155) | |
| Enumeration Date | 2018-03-15 |
| Last Update Date | 2022-02-03 |