NPI | 1619394111 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: FL SW11599) |
Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: FL SW11599) |
103K00000X Behavior Analyst (Licence: FL SW11599) | |
Enumeration Date | 2014-03-21 |
Last Update Date | 2023-12-20 |