| NPI | 1801367065 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: CO LPCC.0020749) |
| Additional Taxonomies | 106S00000X Behavior Technician (Licence: CO RBT-18-72812) |
| Enumeration Date | 2018-12-16 |
| Last Update Date | 2024-03-14 |