| NPI | 1619480340 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: NC A13554) |
| Additional Taxonomies | 106S00000X Behavior Technician (Licence: NC RBT-17-43018) |
| Enumeration Date | 2017-11-16 |
| Last Update Date | 2018-08-02 |