| NPI | 1700354974 |
|---|---|
| Former Name | STEPHANIE PORTILLO |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 106S00000X Behavior Technician |
| Additional Taxonomies | 171M00000X Case Manager/Care Coordinator |
| Enumeration Date | 2018-11-06 |
| Last Update Date | 2020-02-24 |