| NPI | 1255992624 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225400000X Rehabilitation Practitioner |
| Additional Taxonomies | 172V00000X Community Health Worker |
| 106S00000X Behavior Technician | |
| 101Y00000X Counselor | |
| Enumeration Date | 2019-06-25 |
| Last Update Date | 2025-10-13 |