| NPI | 1720559115 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker Clinical (Licence: CA 128753) |
| Additional Taxonomies | 1041C0700X Social Worker Clinical (Licence: CA 104332) |
| 106S00000X Behavior Technician | |
| Enumeration Date | 2018-12-10 |
| Last Update Date | 2025-03-19 |