| NPI | 1124489042 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 106S00000X Behavior Technician (Licence: VA RBT-21-157015) |
| Additional Taxonomies | 222Q00000X Developmental Therapist |
| Enumeration Date | 2016-03-20 |
| Last Update Date | 2023-10-26 |