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 |