| NPI | 1639637416 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: IA 116618) |
| Additional Taxonomies | 106S00000X Behavior Technician |
| Enumeration Date | 2019-03-11 |
| Last Update Date | 2022-10-05 |