| NPI | 1972065399 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225400000X Rehabilitation Practitioner |
| Additional Taxonomies | 101Y00000X Counselor |
| 101YM0800X Counselor Mental Health | |
| 106S00000X Behavior Technician | |
| 171M00000X Case Manager/Care Coordinator | |
| Enumeration Date | 2019-04-03 |
| Last Update Date | 2025-04-21 |