| NPI | 1013409382 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 164W00000X Licensed Practical Nurse (Licence: WA LP61081098) |
| Additional Taxonomies | 106S00000X Behavior Technician |
| Enumeration Date | 2018-06-03 |
| Last Update Date | 2022-05-23 |