| NPI | 1013526763 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: MA LICSW1120410) |
| Additional Taxonomies | 106S00000X Behavior Technician |
| Enumeration Date | 2020-07-29 |
| Last Update Date | 2025-04-09 |