| NPI | 1164048773 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist, (Licence: KS 3558) |
| Additional Taxonomies | 106S00000X Behavior Technician |
| Enumeration Date | 2020-06-19 |
| Last Update Date | 2021-03-05 |