| NPI | 1972011419 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 106S00000X Behavior Technician |
| Additional Taxonomies | 101YM0800X Counselor Mental Health (Licence: NY 004523) |
| Enumeration Date | 2018-01-18 |
| Last Update Date | 2018-03-17 |