| NPI | 1588344311 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor Professional (Licence: GA LPC014938) |
| Additional Taxonomies | 101YP2500X Counselor Professional (Licence: IL 17803913) |
| 106S00000X Behavior Technician | |
| Enumeration Date | 2023-07-18 |
| Last Update Date | 2024-08-19 |