| NPI | 1992293393 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 103K00000X Behavior Analyst | 
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: FL 100189) | 
| Enumeration Date | 2018-05-01 | 
| Last Update Date | 2022-12-22 |