| NPI | 1750866315 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor Mental Health (Licence: CA APCC9004) |
| Additional Taxonomies | 106S00000X Behavior Technician |
| 101YP2500X Counselor Professional (Licence: CA 9004) | |
| Enumeration Date | 2018-09-30 |
| Last Update Date | 2024-03-13 |