| NPI | 1043835200 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 106S00000X Behavior Technician (Licence: GA RBT-20-139479) |
| Additional Taxonomies | 251S00000X Community/Behavioral Health |
| Enumeration Date | 2020-06-13 |
| Last Update Date | 2020-11-05 |