| NPI | 1104220953 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103K00000X Behavior Analyst (Licence: 1-17-25816) |
| Additional Taxonomies | 222Q00000X Developmental Therapist |
| Enumeration Date | 2014-10-21 |
| Last Update Date | 2018-10-25 |