| NPI | 1801313507 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: NY P114681-01) |
| Additional Taxonomies | 106S00000X Behavior Technician |
| Enumeration Date | 2017-08-24 |
| Last Update Date | 2022-05-05 |