| NPI | 1588375760 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor Mental Health (Licence: IA 126405) |
| Additional Taxonomies | 106S00000X Behavior Technician |
| Enumeration Date | 2022-12-08 |
| Last Update Date | 2024-10-24 |