| NPI | 1023582814 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 104100000X Social Worker (Licence: KS LMSW13600-T) |
| Additional Taxonomies | 106S00000X Behavior Technician |
| Enumeration Date | 2019-01-15 |
| Last Update Date | 2024-09-04 |