| NPI | 1639763493 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: SC 11337) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: PA PC019169) |
| 106S00000X Behavior Technician | |
| Enumeration Date | 2021-02-23 |
| Last Update Date | 2025-10-02 |