| NPI | 1790381390 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional |
| Additional Taxonomies | 106S00000X Behavior Technician (Licence: CO RBT-20-143875) |
| Enumeration Date | 2020-12-09 |
| Last Update Date | 2024-01-15 |