| NPI | 1528505450 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: FL SW15707) |
| Additional Taxonomies | 106S00000X Behavior Technician |
| Enumeration Date | 2017-01-30 |
| Last Update Date | 2019-06-10 |