| NPI | 1619542354 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: CA 123371) |
| Additional Taxonomies | 106S00000X Behavior Technician (Licence: CA Y8648844) |
| Enumeration Date | 2021-05-25 |
| Last Update Date | 2024-07-09 |