| NPI | 1619590627 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: IL 180.017988) |
| Additional Taxonomies | 106S00000X Behavior Technician |
| Enumeration Date | 2020-05-26 |
| Last Update Date | 2026-05-18 |