| NPI | 1639769581 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: NV CI5571) |
| Additional Taxonomies | 106S00000X Behavior Technician (Licence: NV 106S00000X) |
| Enumeration Date | 2021-01-25 |
| Last Update Date | 2025-07-14 |