| NPI | 1962024141 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program |
| Additional Taxonomies | 101YP2500X Counselor, Professional |
| 106S00000X Behavior Technician | |
| Enumeration Date | 2020-05-11 |
| Last Update Date | 2024-08-30 |