| NPI | 1104662329 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 171M00000X Case Manager/Care Coordinator |
| Additional Taxonomies | 172V00000X Community Health Worker |
| 175T00000X Peer Specialist | |
| 251B00000X Case Management | |
| 251S00000X Community/Behavioral Health | |
| 106S00000X Behavior Technician | |
| 261QR0401X Clinic/Center, Rehabilitation, Comprehensive Outpatient Rehabilitation Facility (CORF) | |
| 373H00000X Day Training/Habilitation Specialist | |
| Enumeration Date | 2024-07-08 |
| Last Update Date | 2025-04-15 |