| NPI | 1619305794 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103K00000X Behavior Analyst (Licence: ZZ 1-13-14362) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: FL IMH22354) |
| Enumeration Date | 2013-10-28 |
| Last Update Date | 2022-04-06 |