| NPI | 1023516051 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 104100000X Social Worker (Licence: FL CBHCM100372) |
| Additional Taxonomies | 104100000X Social Worker |
| 106S00000X Behavior Technician | |
| 163W00000X Registered Nurse (Licence: FL RN9473880) | |
| Enumeration Date | 2018-01-24 |
| Last Update Date | 2021-09-13 |