| NPI | 1750717112 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 103K00000X Behavior Analyst (Licence: WA CG60369664) | 
| Additional Taxonomies | 101Y00000X Counselor (Licence: WA CG60369664) | 
| Enumeration Date | 2013-09-17 | 
| Last Update Date | 2013-09-17 |