| NPI | 1891331815 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: WA MC61166741) |
| Additional Taxonomies | 106S00000X Behavior Technician (Licence: WA CB60990158) |
| Enumeration Date | 2019-11-25 |
| Last Update Date | 2024-10-30 |