| NPI | 1588126213 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: MA LSWA416480) |
| Additional Taxonomies | 106S00000X Behavior Technician |
| Enumeration Date | 2019-04-02 |
| Last Update Date | 2025-07-26 |