NPI | 1679969018 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: GA LPC007523) |
Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: GA LPC007523) |
106S00000X Behavior Technician | |
Enumeration Date | 2015-04-13 |
Last Update Date | 2024-06-20 |