| NPI | 1972157394 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health |
| Additional Taxonomies | 106S00000X Behavior Technician (Licence: RBT-18-59763) |
| Enumeration Date | 2019-07-25 |
| Last Update Date | 2023-05-05 |