| NPI | 1760129209 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101Y00000X Counselor (Licence: OK LPCCANDIDATE12830) |
| Additional Taxonomies | 106S00000X Behavior Technician |
| Enumeration Date | 2022-05-17 |
| Last Update Date | 2025-08-14 |