| NPI | 1578042099 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: FL ISW16551) |
| Additional Taxonomies | 106S00000X Behavior Technician |
| Enumeration Date | 2018-08-07 |
| Last Update Date | 2022-01-17 |