NPI | 1669954764 |
---|---|
Former Name | VICTORIA JOHNSON |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 171M00000X Case Manager/Care Coordinator (Licence: CA 107898) |
Additional Taxonomies | 106S00000X Behavior Technician |
Enumeration Date | 2018-09-05 |
Last Update Date | 2023-03-24 |