| NPI | 1982105961 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: CA 16371) |
| Additional Taxonomies | 106S00000X Behavior Technician (Licence: CA 00001824) |
| Enumeration Date | 2018-02-23 |
| Last Update Date | 2025-03-05 |