| NPI | 1801308549 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor Mental Health (Licence: FL MH139344) |
| Additional Taxonomies | 106S00000X Behavior Technician |
| Enumeration Date | 2017-11-03 |
| Last Update Date | 2024-03-26 |