| NPI | 1871083790 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: MD LC13337) |
| Additional Taxonomies | 106S00000X Behavior Technician |
| 101YM0800X Counselor, Mental Health (Licence: MD LGP10882) | |
| Enumeration Date | 2018-05-16 |
| Last Update Date | 2023-03-02 |