| NPI | 1760981963 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: MO 2024033530) |
| Additional Taxonomies | 104100000X Social Worker (Licence: IL 150.102764) |
| 106S00000X Behavior Technician (Licence: IL RBT-17-37803) | |
| Enumeration Date | 2018-02-03 |
| Last Update Date | 2025-01-31 |