| NPI | 1598272361 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: CA 89737) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical |
| 1041C0700X Social Worker, Clinical (Licence: MI 6801103733) | |
| 106S00000X Behavior Technician | |
| Enumeration Date | 2018-01-03 |
| Last Update Date | 2023-05-21 |