| NPI | 1164142899 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: CA 308194) |
| Additional Taxonomies | 106S00000X Behavior Technician (Licence: CA RBT-22-232666) |
| Enumeration Date | 2022-09-01 |
| Last Update Date | 2025-06-10 |