| NPI | 1679095673 |
|---|---|
| Former Name | DEVONN TREVINO |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 172V00000X Community Health Worker |
| Additional Taxonomies | 106S00000X Behavior Technician |
| Enumeration Date | 2017-07-11 |
| Last Update Date | 2020-05-15 |