| NPI | 1013417203 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: CA 92063) |
| Additional Taxonomies | 106S00000X Behavior Technician (Licence: CA 00001613) |
| Enumeration Date | 2018-02-14 |
| Last Update Date | 2024-07-18 |