| NPI | 1184313967 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 106S00000X Behavior Technician (Licence: GA RBT-25-486252) |
| Additional Taxonomies | 175T00000X Peer Specialist (Licence: WA CG61455410) |
| 101Y00000X Counselor (Licence: WA CG61455410) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2023-05-05 |
| Last Update Date | 2025-10-29 |