| NPI | 1609469600 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health |
| Additional Taxonomies | 106S00000X Behavior Technician (Licence: OK RBT21-156600) |
| Enumeration Date | 2021-02-19 |
| Last Update Date | 2024-04-16 |