| NPI | 1053961383 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist, (Licence: MO 2023023496) |
| Additional Taxonomies | 106S00000X Behavior Technician (Licence: MO RBT-19-91882) |
| Enumeration Date | 2019-09-18 |
| Last Update Date | 2023-08-21 |