| NPI | 1760948145 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 104100000X Social Worker (Licence: OH S.2005548) |
| Additional Taxonomies | 106S00000X Behavior Technician |
| 171000000X Military Health Care Provider | |
| Enumeration Date | 2019-02-11 |
| Last Update Date | 2020-10-30 |