| NPI | 1669036406 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor Mental Health (Licence: MN STUDENT) |
| Additional Taxonomies | 103K00000X Behavior Analyst |
| Enumeration Date | 2019-04-26 |
| Last Update Date | 2021-05-20 |