| NPI | 1992336556 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker Clinical (Licence: WA 61131132) |
| Additional Taxonomies | 106S00000X Behavior Technician |
| Enumeration Date | 2020-01-31 |
| Last Update Date | 2020-12-15 |