| NPI | 1104471606 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 106S00000X Behavior Technician (Licence: FL RBT-19-82279) |
| Additional Taxonomies | 222Q00000X Developmental Therapist |
| Enumeration Date | 2019-08-02 |
| Last Update Date | 2019-11-14 |