| NPI | 1508364456 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: KY 259639) |
| Additional Taxonomies | 104100000X Social Worker (Licence: OH S.1802408) |
| 106S00000X Behavior Technician | |
| Enumeration Date | 2018-01-25 |
| Last Update Date | 2024-10-09 |