| NPI | 1154871002 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: MT 57510) |
| Additional Taxonomies | 106S00000X Behavior Technician (Licence: WA CB60971891) |
| Enumeration Date | 2016-10-04 |
| Last Update Date | 2024-07-05 |