NPI | 1053015289 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 106S00000X Behavior Technician |
Additional Taxonomies | 106S00000X Behavior Technician |
251S00000X Community/Behavioral Health | |
261QM0801X Clinic/Center Mental Health (Including Community Mental Health Center) | |
Enumeration Date | 2023-03-30 |
Last Update Date | 2025-08-19 |