| NPI | 1770258907 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: KS 04150) |
| Additional Taxonomies | 106S00000X Behavior Technician (Licence: KS RBT21177737) |
| Enumeration Date | 2021-08-10 |
| Last Update Date | 2022-10-28 |