| NPI | 1700652070 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: FL IMH26783) |
| Additional Taxonomies | 106S00000X Behavior Technician |
| Enumeration Date | 2023-11-28 |
| Last Update Date | 2024-11-19 |