| NPI | 1912302316 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor Mental Health (Licence: MA 10148) |
| Additional Taxonomies | 103K00000X Behavior Analyst |
| Enumeration Date | 2014-10-28 |
| Last Update Date | 2017-08-11 |