| NPI | 1942936661 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health |
| Additional Taxonomies | 320800000X Community Based Residential Treatment Facility, Mental Illness |
| 101Y00000X Counselor | |
| 106H00000X Marriage & Family Therapist | |
| 106S00000X Behavior Technician | |
| Enumeration Date | 2022-07-26 |
| Last Update Date | 2022-07-26 |