| NPI | 1366089898 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 175T00000X Peer Specialist |
| Additional Taxonomies | 106S00000X Behavior Technician (Licence: OK RBT-19-96839) |
| 171M00000X Case Manager/Care Coordinator | |
| Enumeration Date | 2019-12-03 |
| Last Update Date | 2023-09-06 |