| NPI | 1780317651 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 104100000X Social Worker (Licence: UT 14267739-3502) |
| Additional Taxonomies | 106S00000X Behavior Technician |
| Enumeration Date | 2022-07-07 |
| Last Update Date | 2026-01-28 |