| NPI | 1942869763 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: MD LC11701) |
| Additional Taxonomies | 106S00000X Behavior Technician |
| Enumeration Date | 2019-06-06 |
| Last Update Date | 2022-08-23 |