| NPI | 1598311532 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: NY 010710) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: NY P12722) |
| 106S00000X Behavior Technician | |
| Enumeration Date | 2019-08-15 |
| Last Update Date | 2020-10-19 |