| NPI | 1821632084 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program |
| Additional Taxonomies | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
| 106S00000X Behavior Technician | |
| Enumeration Date | 2019-10-31 |
| Last Update Date | 2025-09-08 |