| NPI | 1649820317 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101Y00000X Counselor (Licence: OK 11536) |
| Additional Taxonomies | 106S00000X Behavior Technician (Licence: OK K083262361) |
| Enumeration Date | 2019-09-16 |
| Last Update Date | 2023-07-05 |