| NPI | 1407254097 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 106S00000X Behavior Technician |
| Additional Taxonomies | 1041C0700X Social Worker Clinical (Licence: MD 20523) |
| Enumeration Date | 2014-12-12 |
| Last Update Date | 2017-05-08 |