| NPI | 1962995175 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 171W00000X Contractor (Licence: FL 25699) |
| Additional Taxonomies | 103K00000X Behavior Analyst (Licence: FL CBHCM102104) |
| 104100000X Social Worker | |
| Enumeration Date | 2018-06-12 |
| Last Update Date | 2026-02-06 |