| NPI | 1598281289 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor Mental Health |
| Additional Taxonomies | 106S00000X Behavior Technician (Licence: LA R2922) |
| Enumeration Date | 2017-08-15 |
| Last Update Date | 2018-02-21 |