| NPI | 1366291965 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: NC P022534) |
| Additional Taxonomies | 106S00000X Behavior Technician |
| Enumeration Date | 2024-05-15 |
| Last Update Date | 2025-07-16 |