| NPI | 1699413443 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 172V00000X Community Health Worker (Licence: MI P326072373767) |
| Additional Taxonomies | 106S00000X Behavior Technician |
| Enumeration Date | 2022-05-23 |
| Last Update Date | 2022-12-05 |