| NPI | 1104436864 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: OK 21306) |
| Additional Taxonomies | 106S00000X Behavior Technician (Licence: OK RBT-24-350883) |
| Enumeration Date | 2020-08-06 |
| Last Update Date | 2026-03-24 |