NPI | 1952751828 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: WA MC61455478) |
Additional Taxonomies | 225700000X Massage Therapist (Licence: WA MA61206532) |
106S00000X Behavior Technician (Licence: WA CG60674351) | |
Enumeration Date | 2016-06-21 |
Last Update Date | 2023-07-31 |