| NPI | 1346854601 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 171M00000X Case Manager/Care Coordinator |
| Additional Taxonomies | 106S00000X Behavior Technician (Licence: FL RBT-20-128840) |
| Enumeration Date | 2020-09-03 |
| Last Update Date | 2022-01-06 |