| NPI | 1912331067 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor Mental Health (Licence: FL MH11627) |
| Additional Taxonomies | 103K00000X Behavior Analyst |
| Enumeration Date | 2013-08-26 |
| Last Update Date | 2013-08-26 |