| NPI | 1801555149 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: MD LGP12786) |
| Additional Taxonomies | 106S00000X Behavior Technician |
| Enumeration Date | 2021-12-14 |
| Last Update Date | 2022-06-29 |