| 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 |