| NPI | 1063965226 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 175T00000X Peer Specialist |
| Additional Taxonomies | 222Q00000X Developmental Therapist |
| 222Q00000X Developmental Therapist | |
| Enumeration Date | 2016-07-25 |
| Last Update Date | 2020-08-03 |