NPI | 1962914705 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 103K00000X Behavior Analyst (Licence: FL 1-20-45250) |
Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: FL MH14068) |
Enumeration Date | 2017-11-02 |
Last Update Date | 2021-09-02 |