| NPI | 1679012942 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103K00000X Behavior Analyst (Licence: FL MH14825) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: FL MH 14825) |
| Enumeration Date | 2017-02-19 |
| Last Update Date | 2018-04-19 |