| NPI | 1578120168 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: CA 145740) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: CA 10378) |
| 106S00000X Behavior Technician | |
| Enumeration Date | 2019-05-20 |
| Last Update Date | 2024-04-29 |