NPI | 1831634484 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: FL MH15978) |
Additional Taxonomies | 103K00000X Behavior Analyst (Licence: FL 1-20-42767) |
Enumeration Date | 2017-01-05 |
Last Update Date | 2020-11-05 |