| NPI | 1801504204 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 172V00000X Community Health Worker |
| Additional Taxonomies | 106S00000X Behavior Technician |
| 373H00000X Day Training/Habilitation Specialist | |
| 106S00000X Behavior Technician | |
| Enumeration Date | 2022-11-14 |
| Last Update Date | 2026-07-01 |