| NPI | 1093364184 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 104100000X Social Worker (Licence: FL CBHCMS0102821) |
| Additional Taxonomies | 106S00000X Behavior Technician |
| Enumeration Date | 2019-09-10 |
| Last Update Date | 2025-11-14 |