| NPI | 1790225613 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103K00000X Behavior Analyst (Licence: FL MH14780) |
| Additional Taxonomies | 101YM0800X Counselor Mental Health (Licence: FL MH14780) |
| Enumeration Date | 2017-02-24 |
| Last Update Date | 2021-10-04 |