| NPI | 1669881942 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101Y00000X Counselor |
| Additional Taxonomies | 103K00000X Behavior Analyst |
| 133NN1002X Nutritionist, Nutrition, Education | |
| 251S00000X Community/Behavioral Health | |
| 305R00000X Preferred Provider Organization | |
| Enumeration Date | 2014-08-12 |
| Last Update Date | 2014-08-12 |