NPI | 1053879650 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 235Z00000X Speech-Language Pathologist, (Licence: MS S4677) |
Additional Taxonomies | 106S00000X Behavior Technician (Licence: RBT-19-79242) |
Enumeration Date | 2019-03-04 |
Last Update Date | 2020-06-08 |