| NPI | 1578708509 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: FL MH9619) |
| Additional Taxonomies | 103K00000X Behavior Analyst (Licence: FL 1-16-23285) |
| Enumeration Date | 2008-12-04 |
| Last Update Date | 2018-08-24 |