| NPI | 1003494550 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 171M00000X Case Manager/Care Coordinator |
| Additional Taxonomies | 106S00000X Behavior Technician (Licence: OK RBT-21-159669) |
| Enumeration Date | 2021-03-29 |
| Last Update Date | 2022-05-12 |