| NPI | 1962069757 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: OR R8052) |
| Additional Taxonomies | 106S00000X Behavior Technician |
| Enumeration Date | 2019-05-28 |
| Last Update Date | 2022-12-28 |