| NPI | 1982179578 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 171M00000X Case Manager/Care Coordinator (Licence: CBHCM100340) |
| Additional Taxonomies | 103K00000X Behavior Analyst (Licence: FL 1-19-38783) |
| Enumeration Date | 2018-10-10 |
| Last Update Date | 2020-02-26 |