| NPI | 1053066464 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program |
| Additional Taxonomies | 103K00000X Behavior Analyst |
| 172V00000X Community Health Worker | |
| 175T00000X Peer Specialist | |
| Enumeration Date | 2022-02-14 |
| Last Update Date | 2025-07-31 |