| NPI | 1891067401 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: FL SW14584) |
| Additional Taxonomies | 106S00000X Behavior Technician (Licence: FL RBT-19-78729) |
| Enumeration Date | 2012-01-30 |
| Last Update Date | 2021-09-21 |