| NPI | 1831784099 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101Y00000X Counselor (Licence: UT 14280226-6004) |
| Additional Taxonomies | 106S00000X Behavior Technician |
| 101Y00000X Counselor (Licence: AZ LPC-08090T) | |
| Enumeration Date | 2021-03-09 |
| Last Update Date | 2026-04-26 |