| NPI | 1104498526 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 106S00000X Behavior Technician (Licence: FL RBT-23-296688) | 
| Additional Taxonomies | 171M00000X Case Manager/Care Coordinator | 
| Enumeration Date | 2021-07-14 | 
| Last Update Date | 2023-11-08 |