| NPI | 1720494628 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103K00000X Behavior Analyst (Licence: 1-22-59860) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: VA 0701005858) |
| Enumeration Date | 2014-07-11 |
| Last Update Date | 2022-09-09 |