| NPI | 1629635552 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program |
| Additional Taxonomies | 172V00000X Community Health Worker |
| 106S00000X Behavior Technician | |
| Enumeration Date | 2019-05-27 |
| Last Update Date | 2024-07-02 |