| NPI | 1992246961 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: FL MH14419) |
| Additional Taxonomies | 103K00000X Behavior Analyst (Licence: FL MH14419) |
| Enumeration Date | 2017-03-10 |
| Last Update Date | 2020-04-02 |