| NPI | 1710685045 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 167G00000X Licensed Psychiatric Technician (Licence: CA PT38056) |
| Additional Taxonomies | 106S00000X Behavior Technician |
| Enumeration Date | 2023-02-16 |
| Last Update Date | 2024-11-11 |