| NPI | 1154885267 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist, (Licence: SC 7215) |
| Additional Taxonomies | 106S00000X Behavior Technician (Licence: RBT-17-40999) |
| Enumeration Date | 2019-01-23 |
| Last Update Date | 2021-05-18 |