| NPI | 1710333745 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: FL MH14084) | 
| Additional Taxonomies | 103K00000X Behavior Analyst (Licence: MH14084) | 
| Enumeration Date | 2016-05-09 | 
| Last Update Date | 2023-02-07 |