| NPI | 1861013310 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 104100000X Social Worker (Licence: FL CBHCM102437) |
| Additional Taxonomies | 106S00000X Behavior Technician (Licence: FL RBT-24-335841) |
| Enumeration Date | 2020-05-06 |
| Last Update Date | 2024-04-03 |