| NPI | 1790214641 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101Y00000X Counselor (Licence: FL MH21618) |
| Additional Taxonomies | 106E00000X Assistant Behavior Analyst |
| 101YM0800X Counselor, Mental Health (Licence: FL MH21618) | |
| Enumeration Date | 2017-06-05 |
| Last Update Date | 2023-07-09 |