| NPI | 1104563634 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103K00000X Behavior Analyst |
| Additional Taxonomies | 106S00000X Behavior Technician |
| 225100000X Physical Therapist | |
| 225X00000X Occupational Therapist | |
| 235Z00000X Speech-Language Pathologist | |
| Enumeration Date | 2022-05-16 |
| Last Update Date | 2022-05-16 |