| NPI | 1619481413 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| 106S00000X Behavior Technician (Licence: CA RBT-17-33838) | |
| Enumeration Date | 2017-12-01 |
| Last Update Date | 2020-02-05 |