| NPI | 1750849972 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: FL IMH25050) |
| Additional Taxonomies | 106S00000X Behavior Technician (Licence: FL RBT-16-23025) |
| Enumeration Date | 2019-03-06 |
| Last Update Date | 2024-01-31 |