| NPI | 1790500387 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225400000X Rehabilitation Practitioner |
| Additional Taxonomies | 172V00000X Community Health Worker |
| 106S00000X Behavior Technician | |
| Enumeration Date | 2024-11-19 |
| Last Update Date | 2025-04-22 |