| NPI | 1689057697 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103K00000X Behavior Analyst (Licence: GA 1-24-74523) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: KY 253126) |
| 103K00000X Behavior Analyst (Licence: TN 1-24-74523) | |
| 1041C0700X Social Worker, Clinical (Licence: KY 253126) | |
| 106S00000X Behavior Technician (Licence: KY RBT-17-28128) | |
| Enumeration Date | 2015-07-08 |
| Last Update Date | 2025-09-12 |