| NPI | 1861032625 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker Clinical (Licence: WA SC61510501) |
| Additional Taxonomies | 106S00000X Behavior Technician |
| Enumeration Date | 2020-01-09 |
| Last Update Date | 2024-01-22 |