| NPI | 1932839735 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: MO 2019044883) |
| Additional Taxonomies | 106S00000X Behavior Technician (Licence: RBT-22-231377) |
| Enumeration Date | 2022-06-14 |
| Last Update Date | 2022-08-25 |