| NPI | 1992207484 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker Clinical (Licence: WA SC61110629) |
| Additional Taxonomies | 101Y00000X Counselor |
| 104100000X Social Worker (Licence: WA SC61110629) | |
| 106S00000X Behavior Technician | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2018-03-01 |
| Last Update Date | 2022-08-10 |