| NPI | 1790056125 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: NE 5161) |
| Additional Taxonomies | 103K00000X Behavior Analyst |
| Enumeration Date | 2012-01-17 |
| Last Update Date | 2018-07-16 |