| NPI | 1700530573 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: NC p019324) |
| Additional Taxonomies | 106S00000X Behavior Technician (Licence: PA RBT-22-201380) |
| Enumeration Date | 2022-02-09 |
| Last Update Date | 2024-06-22 |