| NPI | 1578298105 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: OR R8913) |
| Additional Taxonomies | 106S00000X Behavior Technician |
| Enumeration Date | 2022-07-18 |
| Last Update Date | 2025-03-11 |