| NPI | 1659084259 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Additional Taxonomies | 106S00000X Behavior Technician |
| 251S00000X Community/Behavioral Health | |
| Enumeration Date | 2022-12-29 |
| Last Update Date | 2025-06-03 |