| NPI | 1962984609 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101Y00000X Counselor |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| 106S00000X Behavior Technician (Licence: CA RBT-18-63442) | |
| Enumeration Date | 2018-08-29 |
| Last Update Date | 2019-08-01 |