| NPI | 1679219224 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: AZ LPC-20929) |
| Additional Taxonomies | 106S00000X Behavior Technician (Licence: AZ LPC-20929) |
| Enumeration Date | 2022-05-06 |
| Last Update Date | 2023-02-09 |