| NPI | 1407507858 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 171M00000X Case Manager/Care Coordinator | 
| Additional Taxonomies | 106S00000X Behavior Technician | 
| 251B00000X Case Management | |
| Enumeration Date | 2022-01-17 | 
| Last Update Date | 2022-06-06 |