| NPI | 1164926663 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: CA 121411) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: NC C017816) |
| 106S00000X Behavior Technician | |
| Enumeration Date | 2018-03-20 |
| Last Update Date | 2024-12-17 |