| NPI | 1396251864 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: KS 06097) |
| Additional Taxonomies | 104100000X Social Worker (Licence: KS 11759) |
| 106S00000X Behavior Technician | |
| Enumeration Date | 2017-12-20 |
| Last Update Date | 2023-06-12 |