| NPI | 1962992016 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: FL ISW14899) |
| Additional Taxonomies | 106S00000X Behavior Technician |
| Enumeration Date | 2018-05-15 |
| Last Update Date | 2021-03-30 |