| NPI | 1770051492 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 171M00000X Case Manager/Care Coordinator |
| Additional Taxonomies | 103T00000X Psychologist |
| 106S00000X Behavior Technician | |
| 225400000X Rehabilitation Practitioner | |
| Enumeration Date | 2018-11-12 |
| Last Update Date | 2022-07-12 |