| NPI | 1578991154 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: FL MH16110) |
| Additional Taxonomies | 106S00000X Behavior Technician |
| Enumeration Date | 2013-10-17 |
| Last Update Date | 2019-10-23 |