| NPI | 1114573052 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: ID 8861418) |
| Additional Taxonomies | 106S00000X Behavior Technician |
| Enumeration Date | 2019-08-15 |
| Last Update Date | 2025-05-08 |