| NPI | 1174366728 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: NC p022583) |
| Additional Taxonomies | 106S00000X Behavior Technician |
| Enumeration Date | 2024-06-13 |
| Last Update Date | 2025-10-31 |