| NPI | 1841791373 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: FL MH23251) |
| Additional Taxonomies | 106S00000X Behavior Technician (Licence: FL 433322) |
| Enumeration Date | 2018-02-21 |
| Last Update Date | 2024-01-25 |