| NPI | 1689079246 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: NE 11867) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: NE 11867) |
| 106S00000X Behavior Technician | |
| Enumeration Date | 2014-10-24 |
| Last Update Date | 2020-05-21 |