| NPI | 1669174280 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: MI 6451022884) |
| Additional Taxonomies | 106S00000X Behavior Technician (Licence: MI 6451022884) |
| Enumeration Date | 2023-03-20 |
| Last Update Date | 2024-02-17 |