| NPI | 1346951019 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 172V00000X Community Health Worker (Licence: UT 0) |
| Additional Taxonomies | 106S00000X Behavior Technician (Licence: UT RBT-24-395369) |
| Enumeration Date | 2022-12-13 |
| Last Update Date | 2025-05-12 |