| NPI | 1679397004 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 175T00000X Peer Specialist (Licence: CA MPSS-VQXKHD) |
| Additional Taxonomies | 106S00000X Behavior Technician |
| Enumeration Date | 2024-11-12 |
| Last Update Date | 2025-12-24 |