NPI | 1720636160 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: VA 0904013661) |
Additional Taxonomies | 106S00000X Behavior Technician |
Enumeration Date | 2019-08-29 |
Last Update Date | 2022-02-15 |