| NPI | 1639668353 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: CA LPCC19454) |
| Additional Taxonomies | 106S00000X Behavior Technician (Licence: CA RBT-18-48872) |
| 101YM0800X Counselor, Mental Health (Licence: CA APCC8941) | |
| Enumeration Date | 2018-05-08 |
| Last Update Date | 2025-05-20 |