| NPI | 1982278180 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: NC A20065) |
| Additional Taxonomies | 106S00000X Behavior Technician |
| Enumeration Date | 2021-05-13 |
| Last Update Date | 2026-01-21 |