| NPI | 1720632938 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor Mental Health (Licence: WA LH61518758) |
| Additional Taxonomies | 106S00000X Behavior Technician |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2019-07-25 |
| Last Update Date | 2024-03-28 |