| NPI | 1649723578 |
|---|---|
| Professional Name | N/A N/A N/A |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103K00000X Behavior Analyst (Licence: FL MH14228) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: FL MH14228) |
| Enumeration Date | 2016-07-27 |
| Last Update Date | 2021-03-12 |