| NPI | 1104213149 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103K00000X Behavior Analyst (Licence: MA 2976) |
| Additional Taxonomies | 222Q00000X Developmental Therapist |
| Enumeration Date | 2015-04-16 |
| Last Update Date | 2020-02-24 |