| NPI | 1043572571 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker Clinical (Licence: MA 219887) |
| Additional Taxonomies | 103K00000X Behavior Analyst (Licence: 1-15-20973) |
| 1041S0200X Social Worker School (Licence: MA DOE 479924) | |
| Enumeration Date | 2012-06-11 |
| Last Update Date | 2021-08-25 |