| NPI | 1962939660 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: HI MHC525) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: RI MHC00861) |
| 101YM0800X Counselor, Mental Health (Licence: MA 9602) | |
| 103K00000X Behavior Analyst | |
| Enumeration Date | 2017-05-12 |
| Last Update Date | 2022-07-22 |