| NPI | 1639423791 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor Professional (Licence: NM 0164321) |
| Additional Taxonomies | 103K00000X Behavior Analyst (Licence: 103K00000X) |
| Enumeration Date | 2012-10-28 |
| Last Update Date | 2014-02-12 |