| NPI | 1699148122 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103K00000X Behavior Analyst (Licence: CT 1-17-28659) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: CT 2844) |
| Enumeration Date | 2015-11-05 |
| Last Update Date | 2022-04-08 |