| NPI | 1689174070 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health |
| Additional Taxonomies | 106S00000X Behavior Technician (Licence: KY 18-49085) |
| Enumeration Date | 2018-02-13 |
| Last Update Date | 2021-09-08 |