| NPI | 1679423693 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: NC A22755) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: NC A22755) |
| 106S00000X Behavior Technician | |
| 101Y00000X Counselor (Licence: NC A22755) | |
| Enumeration Date | 2026-01-29 |
| Last Update Date | 2026-07-14 |