| NPI | 1487982146 |
|---|---|
| Entity Type | Individual |
| Gender | N/A |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: FL SW 6227) |
| Additional Taxonomies | 103K00000X Behavior Analyst |
| Enumeration Date | 2009-11-18 |
| Last Update Date | 2025-02-19 |