| NPI | 1700228731 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 101YM0800X Counselor, Mental Health | 
| Additional Taxonomies | 103K00000X Behavior Analyst | 
| 103TB0200X Psychologist, Cognitive & Behavioral | |
| Enumeration Date | 2013-07-18 | 
| Last Update Date | 2017-02-28 |