| NPI | 1215519673 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103K00000X Behavior Analyst (Licence: PA 1-22-60222) |
| Additional Taxonomies | 172V00000X Community Health Worker (Licence: PA BH004700) |
| Enumeration Date | 2021-04-26 |
| Last Update Date | 2023-02-03 |