| NPI | 1679227748 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: AL ALC04779) |
| Additional Taxonomies | 106S00000X Behavior Technician (Licence: RBT-21-190282) |
| Enumeration Date | 2022-02-08 |
| Last Update Date | 2024-01-31 |