| NPI | 1588933014 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor Mental Health (Licence: NE 10297) |
| Additional Taxonomies | 103K00000X Behavior Analyst (Licence: MO 0-11-4299) |
| Enumeration Date | 2011-12-29 |
| Last Update Date | 2015-07-16 |