| NPI | 1053898791 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 104100000X Social Worker (Licence: AK 162673) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: AK 162673) |
| 106S00000X Behavior Technician | |
| Enumeration Date | 2018-07-25 |
| Last Update Date | 2021-01-26 |