| NPI | 1083125439 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: AR 5043) |
| Additional Taxonomies | 106S00000X Behavior Technician (Licence: AR RBT-18-51982) |
| Enumeration Date | 2017-10-12 |
| Last Update Date | 2021-08-19 |