| NPI | 1689035065 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: NC A18736) |
| Additional Taxonomies | 106S00000X Behavior Technician |
| 247200000X Technician, Other | |
| Enumeration Date | 2016-03-14 |
| Last Update Date | 2023-05-05 |