| NPI | 1124701511 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program |
| Additional Taxonomies | 106S00000X Behavior Technician (Licence: NY RBT-23-268279) |
| Enumeration Date | 2023-08-10 |
| Last Update Date | 2025-03-26 |