| NPI | 1770154817 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: NE 13487) |
| Additional Taxonomies | 106S00000X Behavior Technician (Licence: MS RBT-21-173834) |
| Enumeration Date | 2021-07-09 |
| Last Update Date | 2023-07-26 |