| NPI | 1790211803 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: WA SC61502004) |
| Additional Taxonomies | 101Y00000X Counselor |
| 106S00000X Behavior Technician (Licence: WA CB60777218) | |
| Enumeration Date | 2017-05-10 |
| Last Update Date | 2024-08-09 |