| NPI | 1104390558 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103K00000X Behavior Analyst (Licence: FL 1-19-36025) |
| Additional Taxonomies | 103K00000X Behavior Analyst (Licence: FL 0189255) |
| Enumeration Date | 2019-01-18 |
| Last Update Date | 2022-02-15 |