| NPI | 1659968774 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: FL MH26132) |
| Additional Taxonomies | 106S00000X Behavior Technician |
| Enumeration Date | 2020-12-22 |
| Last Update Date | 2025-08-25 |