| NPI | 1922792498 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: NM SWB-2024-0691) |
| Additional Taxonomies | 106S00000X Behavior Technician |
| Enumeration Date | 2023-06-06 |
| Last Update Date | 2024-08-16 |