| NPI | 1124797006 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 106S00000X Behavior Technician (Licence: RBT26-506689) |
| Additional Taxonomies | 172V00000X Community Health Worker |
| Enumeration Date | 2021-09-13 |
| Last Update Date | 2026-01-22 |