| NPI | 1750856431 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101Y00000X Counselor (Licence: WA CG60936499) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: WA CG60936499) |
| 106S00000X Behavior Technician | |
| Enumeration Date | 2018-10-09 |
| Last Update Date | 2021-04-06 |