| NPI | 1962748848 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor Mental Health (Licence: WA LF60889308) |
| Additional Taxonomies | 103K00000X Behavior Analyst |
| Enumeration Date | 2012-12-20 |
| Last Update Date | 2020-12-10 |