| NPI | 1902448780 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor Mental Health |
| Additional Taxonomies | 106S00000X Behavior Technician (Licence: CA 46-1305562) |
| Enumeration Date | 2019-10-12 |
| Last Update Date | 2021-05-10 |