NPI | 1104380104 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 103K00000X Behavior Analyst (Licence: MO 1-19-40137) |
Additional Taxonomies | 106S00000X Behavior Technician (Licence: RBT-18-57429) |
Enumeration Date | 2019-01-24 |
Last Update Date | 2020-04-06 |