| NPI | 1679874374 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103K00000X Behavior Analyst (Licence: FL 1-01-0508) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: FL 4750 (CAP)) |
| 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: FL 703172 (IC&RC)) | |
| 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: FL SAP-DOT Approved) | |
| Enumeration Date | 2010-11-11 |
| Last Update Date | 2010-11-13 |