| NPI | 1932746831 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: MA LICSW1120715) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: MA 1120715) |
| 1041C0700X Social Worker, Clinical (Licence: MA 228133LCSW) | |
| 106S00000X Behavior Technician | |
| Enumeration Date | 2019-12-10 |
| Last Update Date | 2025-03-10 |