| NPI | 1023676111 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 104100000X Social Worker |
| Additional Taxonomies | 101Y00000X Counselor (Licence: UT 114713623503) |
| 106S00000X Behavior Technician | |
| Enumeration Date | 2019-06-03 |
| Last Update Date | 2023-11-15 |