| NPI | 1760036867 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health |
| Additional Taxonomies | 106S00000X Behavior Technician (Licence: GA RBT-19-85734) |
| 106S00000X Behavior Technician | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2019-07-26 |
| Last Update Date | 2024-06-20 |