| NPI | 1609377837 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 172V00000X Community Health Worker |
| Additional Taxonomies | 106S00000X Behavior Technician |
| 251S00000X Community/Behavioral Health | |
| Enumeration Date | 2018-02-22 |
| Last Update Date | 2022-03-23 |