| NPI | 1639676703 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: SC 9404) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: SC 7817) |
| 106S00000X Behavior Technician (Licence: SC 17-46991) | |
| Enumeration Date | 2018-04-06 |
| Last Update Date | 2024-01-17 |