| NPI | 1104226042 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 106S00000X Behavior Technician (Licence: FL RBT-18-56115) |
| Additional Taxonomies | 225700000X Massage Therapist (Licence: FL 53159) |
| Enumeration Date | 2014-08-28 |
| Last Update Date | 2018-07-19 |