| NPI | 1760839625 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: FL MH19420) |
| Additional Taxonomies | 103K00000X Behavior Analyst |
| Enumeration Date | 2016-05-20 |
| Last Update Date | 2026-03-18 |