| NPI | 1700437530 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor Mental Health (Licence: FL MH24396) |
| Additional Taxonomies | 106S00000X Behavior Technician (Licence: FL RBT-19-99394) |
| Enumeration Date | 2019-09-23 |
| Last Update Date | 2024-10-02 |