| NPI | 1770157612 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 171M00000X Case Manager/Care Coordinator |
| Additional Taxonomies | 101YM0800X Counselor Mental Health |
| 106S00000X Behavior Technician | |
| Enumeration Date | 2021-05-15 |
| Last Update Date | 2023-04-26 |