| NPI | 1629533948 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101Y00000X Counselor |
| Additional Taxonomies | 106S00000X Behavior Technician (Licence: CA RBT-19-75797) |
| 106S00000X Behavior Technician (Licence: CA 19-75797) | |
| Enumeration Date | 2019-02-01 |
| Last Update Date | 2021-09-20 |