| NPI | 1639614407 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: CA 102751) |
| Additional Taxonomies | 106S00000X Behavior Technician |
| Enumeration Date | 2017-01-03 |
| Last Update Date | 2023-07-31 |