| NPI | 1710336227 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: FL MH17340) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: FL MH17340) |
| 106S00000X Behavior Technician | |
| Enumeration Date | 2016-06-06 |
| Last Update Date | 2021-06-08 |