| NPI | 1619360864 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: WA MC61119848) |
| Additional Taxonomies | 103K00000X Behavior Analyst (Licence: WA AB61106724) |
| Enumeration Date | 2015-03-12 |
| Last Update Date | 2022-03-02 |