| NPI | 1588129555 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: CA 95621) |
| Additional Taxonomies | 106S00000X Behavior Technician (Licence: CA rbt-19-74893) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2019-02-04 |
| Last Update Date | 2021-06-28 |