| NPI | 1730825936 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 106S00000X Behavior Technician (Licence: WV RBT-25-429095) |
| Additional Taxonomies | 172V00000X Community Health Worker |
| Enumeration Date | 2022-05-10 |
| Last Update Date | 2025-05-01 |