| NPI | 1538695366 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 104100000X Social Worker (Licence: ASW124740) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: CA ACSW124740) |
| 104100000X Social Worker (Licence: ID 43911) | |
| 106S00000X Behavior Technician | |
| Enumeration Date | 2017-05-11 |
| Last Update Date | 2026-02-09 |