| NPI | 1679226104 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: NC P022483) |
| Additional Taxonomies | 106S00000X Behavior Technician |
| Enumeration Date | 2022-02-03 |
| Last Update Date | 2026-05-11 |