| NPI | 1922772391 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: FL MH26062) |
| Additional Taxonomies | 106S00000X Behavior Technician |
| Enumeration Date | 2021-08-09 |
| Last Update Date | 2025-07-22 |