| NPI | 1700119633 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: FL MH23592) |
| Additional Taxonomies | 103K00000X Behavior Analyst |
| Enumeration Date | 2009-09-10 |
| Last Update Date | 2026-10-08 |