| NPI | 1720510811 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: NC A15556) |
| Additional Taxonomies | 106S00000X Behavior Technician |
| 221700000X Art Therapist (Licence: TN 19-329) | |
| Enumeration Date | 2017-03-29 |
| Last Update Date | 2021-01-27 |