| NPI | 1053995548 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225400000X Rehabilitation Practitioner |
| Additional Taxonomies | 106S00000X Behavior Technician |
| 251S00000X Community/Behavioral Health | |
| Enumeration Date | 2021-05-11 |
| Last Update Date | 2025-08-12 |