| NPI | 1669040176 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: WA SC1540051) |
| Additional Taxonomies | 106S00000X Behavior Technician (Licence: MS 21171671) |
| Enumeration Date | 2021-06-12 |
| Last Update Date | 2024-05-21 |