| NPI | 1598419624 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: MT 70612) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist |
| 106S00000X Behavior Technician (Licence: CO 21186157) | |
| 106S00000X Behavior Technician (Licence: CO RBT-21-186157) | |
| Enumeration Date | 2022-02-08 |
| Last Update Date | 2024-07-16 |