| NPI | 1871096255 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: FL IMH22287) |
| Additional Taxonomies | 106S00000X Behavior Technician (Licence: FL RBT-18-49743) |
| Enumeration Date | 2018-03-13 |
| Last Update Date | 2022-08-23 |