| NPI | 1780247213 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: NY 18098734-00) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: NY 011249-01) |
| 101YP2500X Counselor, Professional (Licence: NJ 37PC00-14400) | |
| 106S00000X Behavior Technician | |
| Enumeration Date | 2019-04-19 |
| Last Update Date | 2023-12-27 |