| NPI | 1114536596 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 172V00000X Community Health Worker |
| Additional Taxonomies | 101Y00000X Counselor |
| 106S00000X Behavior Technician | |
| Enumeration Date | 2020-07-30 |
| Last Update Date | 2023-05-24 |