| NPI | 1932797701 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: OR R6217) |
| Additional Taxonomies | 103K00000X Behavior Analyst (Licence: 1-18-31449) |
| Enumeration Date | 2021-01-06 |
| Last Update Date | 2021-01-06 |