| NPI | 1104242627 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103K00000X Behavior Analyst (Licence: VA 0133000901) |
| Additional Taxonomies | 103K00000X Behavior Analyst (Licence: MA 1-13-14294) |
| Enumeration Date | 2014-03-07 |
| Last Update Date | 2017-10-20 |