| NPI | 1649691544 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: MT BBH-LCSW-LIC-72689.) |
| Additional Taxonomies | 103K00000X Behavior Analyst (Licence: 1-13-14176) |
| 1041C0700X Social Worker, Clinical (Licence: UT 293034-3502) | |
| Enumeration Date | 2013-12-18 |
| Last Update Date | 2025-01-15 |