| NPI | 1891344222 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: WA LH61330309) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: WA MC61109282) |
| 106S00000X Behavior Technician | |
| Enumeration Date | 2019-09-09 |
| Last Update Date | 2025-09-24 |