| NPI | 1639684343 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: SC 10890) |
| Additional Taxonomies | 106S00000X Behavior Technician |
| Enumeration Date | 2017-12-05 |
| Last Update Date | 2025-05-07 |