| NPI | 1881274629 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor Mental Health (Licence: MD LGP14113) |
| Additional Taxonomies | 106S00000X Behavior Technician |
| Enumeration Date | 2021-04-14 |
| Last Update Date | 2023-08-04 |