| NPI | 1750631214 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: WA MC60354175) |
| Additional Taxonomies | 103K00000X Behavior Analyst (Licence: WA BA60761525) |
| Enumeration Date | 2012-09-12 |
| Last Update Date | 2025-10-03 |