| NPI | 1962977447 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101Y00000X Counselor (Licence: WA CG61139749) |
| Additional Taxonomies | 101Y00000X Counselor |
| 101YM0800X Counselor, Mental Health | |
| 106S00000X Behavior Technician (Licence: WA RBT-15-09036) | |
| Enumeration Date | 2018-10-10 |
| Last Update Date | 2021-03-04 |