| NPI | 1811429665 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: FL ISW 5528) |
| Additional Taxonomies | 106S00000X Behavior Technician |
| Enumeration Date | 2017-03-31 |
| Last Update Date | 2017-03-31 |