| NPI | 1194371781 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: CA 115655) |
| Additional Taxonomies | 106S00000X Behavior Technician |
| Enumeration Date | 2019-08-10 |
| Last Update Date | 2023-06-07 |