| NPI | 1104501238 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 171M00000X Case Manager/Care Coordinator |
| Additional Taxonomies | 106S00000X Behavior Technician (Licence: RBT-23-269772) |
| Enumeration Date | 2023-06-16 |
| Last Update Date | 2023-09-26 |