| NPI | 1639455884 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: FL 25576) |
| Additional Taxonomies | 103K00000X Behavior Analyst |
| Enumeration Date | 2011-11-01 |
| Last Update Date | 2026-03-10 |