| NPI | 1942724562 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: CA 131608) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| 106S00000X Behavior Technician (Licence: CA RBT-18-69573) | |
| Enumeration Date | 2017-07-26 |
| Last Update Date | 2022-03-15 |