| NPI | 1710590369 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 172V00000X Community Health Worker |
| Additional Taxonomies | 101Y00000X Counselor |
| 101YM0800X Counselor, Mental Health | |
| 106S00000X Behavior Technician | |
| Enumeration Date | 2020-08-24 |
| Last Update Date | 2023-05-11 |