| NPI | 1124614813 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103K00000X Behavior Analyst (Licence: GA 1-21-49657) |
| Additional Taxonomies | 106S00000X Behavior Technician |
| 251S00000X Community/Behavioral Health | |
| Enumeration Date | 2020-12-16 |
| Last Update Date | 2021-06-15 |