| NPI | 1386128668 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: MA 107468) |
| Additional Taxonomies | 106S00000X Behavior Technician (Licence: MA 107468) |
| Enumeration Date | 2018-09-21 |
| Last Update Date | 2018-09-21 |