| NPI | 1679112049 |
|---|---|
| Former Name | AUTUMN MARIE PARKER |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 172V00000X Community Health Worker |
| Additional Taxonomies | 106S00000X Behavior Technician |
| Enumeration Date | 2020-01-02 |
| Last Update Date | 2024-01-04 |