| NPI | 1770290728 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 103K00000X Behavior Analyst (Licence: FL 1-24-75751)  | 
| Additional Taxonomies | 101YM0800X Counselor, Mental Health | 
| Enumeration Date | 2022-10-31 | 
| Last Update Date | 2024-09-17 |