NPI | 1699439513 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: IMH23625) |
Additional Taxonomies | 103K00000X Behavior Analyst (Licence: FL RBT-20-147677) |
Enumeration Date | 2021-10-27 |
Last Update Date | 2024-07-25 |