| NPI | 1114690930 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 167G00000X Licensed Psychiatric Technician (Licence: CA 42103) |
| Additional Taxonomies | 106S00000X Behavior Technician |
| Enumeration Date | 2021-07-28 |
| Last Update Date | 2024-12-06 |