| NPI | 1891392890 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: VA 0704015413) |
| Additional Taxonomies | 106S00000X Behavior Technician (Licence: VA RBT-20-137898) |
| Enumeration Date | 2020-10-03 |
| Last Update Date | 2024-02-12 |