| NPI | 1912326638 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103K00000X Behavior Analyst (Licence: 1-13-14177) |
| Additional Taxonomies | 101YP2500X Counselor Professional (Licence: ID LPC-4741) |
| Enumeration Date | 2014-04-09 |
| Last Update Date | 2014-04-09 |