| NPI | 1649736471 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: MI 6451024049) |
| Additional Taxonomies | 106S00000X Behavior Technician |
| Enumeration Date | 2019-02-18 |
| Last Update Date | 2024-11-19 |