| NPI | 1790167963 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: PA PC008691) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: FL MH20233) |
| 103K00000X Behavior Analyst (Licence: PA BH000900) | |
| Enumeration Date | 2015-06-24 |
| Last Update Date | 2022-03-06 |