| NPI | 1942791223 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: VA 0704015246) |
| Additional Taxonomies | 106S00000X Behavior Technician |
| Enumeration Date | 2018-05-23 |
| Last Update Date | 2023-10-12 |