| NPI | 1790351963 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor Mental Health |
| Additional Taxonomies | 106S00000X Behavior Technician (Licence: CO RBT-21-169470) |
| Enumeration Date | 2021-05-28 |
| Last Update Date | 2022-06-13 |