| NPI | 1760199004 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: UT 14220747-3502) |
| Additional Taxonomies | 106S00000X Behavior Technician |
| Enumeration Date | 2022-11-04 |
| Last Update Date | 2025-09-29 |