| NPI | 1912554940 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor Professional (Licence: CA 16177) |
| Additional Taxonomies | 172V00000X Community Health Worker |
| 101Y00000X Counselor | |
| 106S00000X Behavior Technician | |
| Enumeration Date | 2019-08-23 |
| Last Update Date | 2024-05-21 |