| NPI | 1740847227 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: OR L11476) |
| Additional Taxonomies | 106S00000X Behavior Technician (Licence: TX RBT-19-87318) |
| Enumeration Date | 2019-05-21 |
| Last Update Date | 2024-03-07 |