| NPI | 1164170932 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 252Y00000X Early Intervention Provider Agency |
| Additional Taxonomies | 106S00000X Behavior Technician (Licence: FL RBT-19-89497) |
| Enumeration Date | 2022-03-11 |
| Last Update Date | 2024-02-16 |