| NPI | 1700028255 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103K00000X Behavior Analyst (Licence: 1-22-59012) |
| Additional Taxonomies | 101YM0800X Counselor Mental Health (Licence: FL MH 5330) |
| Enumeration Date | 2009-03-30 |
| Last Update Date | 2022-06-03 |