| NPI | 1790173631 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: KY 103551) |
| Additional Taxonomies | 103K00000X Behavior Analyst (Licence: KY KY-0015) |
| Enumeration Date | 2014-12-30 |
| Last Update Date | 2022-09-02 |