| NPI | 1649620386 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: CO NLC.0104360) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: MD LC10116) |
| 101YM0800X Counselor, Mental Health (Licence: MT BBH-LCPC-LIC-30835) | |
| 106S00000X Behavior Technician (Licence: WY RBT-19-93615) | |
| Enumeration Date | 2016-06-14 |
| Last Update Date | 2020-07-24 |