| NPI | 1609418466 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: OR R7745) |
| Additional Taxonomies | 106S00000X Behavior Technician (Licence: OR ABA-IN-10203718) |
| Enumeration Date | 2019-10-14 |
| Last Update Date | 2022-08-01 |