| NPI | 1588413363 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: MO 2024017782) |
| Additional Taxonomies | 106S00000X Behavior Technician |
| Enumeration Date | 2024-05-15 |
| Last Update Date | 2024-05-21 |