| NPI | 1104092584 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103K00000X Behavior Analyst (Licence: FL 11415726) |
| Additional Taxonomies | 101YM0800X Counselor Mental Health (Licence: FL IMH 10390) |
| 222Q00000X Developmental Therapist | |
| Enumeration Date | 2008-05-05 |
| Last Update Date | 2020-06-25 |