| NPI | 1972269108 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor Mental Health (Licence: FL IMH27063) |
| Additional Taxonomies | 106S00000X Behavior Technician (Licence: AL RBT-20-124329) |
| Enumeration Date | 2021-11-11 |
| Last Update Date | 2025-03-19 |