| NPI | 1609390426 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: FL MH17371) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: FL 16392) |
| 222Q00000X Developmental Therapist | |
| 252Y00000X Early Intervention Provider Agency | |
| Enumeration Date | 2017-08-02 |
| Last Update Date | 2024-01-24 |