| NPI | 1649692773 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103K00000X Behavior Analyst (Licence: FL D426012878330) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: FL D426012878330) |
| 101YP2500X Counselor, Professional (Licence: FL D426012878330) | |
| Enumeration Date | 2014-01-08 |
| Last Update Date | 2022-07-21 |