| NPI | 1104598846 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 164W00000X Licensed Practical Nurse (Licence: VA 0002092046) |
| Additional Taxonomies | 106S00000X Behavior Technician |
| Enumeration Date | 2021-09-30 |
| Last Update Date | 2024-10-30 |