| NPI | 1770256745 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: FL SW21272) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: IN 34009766A) |
| 106S00000X Behavior Technician | |
| Enumeration Date | 2021-07-27 |
| Last Update Date | 2023-07-24 |