| NPI | 1790348639 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 104100000X Social Worker (Licence: CT 006311) |
| Additional Taxonomies | 106S00000X Behavior Technician (Licence: CT RBT-19-84158) |
| Enumeration Date | 2019-04-16 |
| Last Update Date | 2023-01-30 |