| NPI | 1174030670 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103K00000X Behavior Analyst (Licence: FL 12582361) |
| Additional Taxonomies | 222Q00000X Developmental Therapist |
| Enumeration Date | 2018-01-05 |
| Last Update Date | 2025-07-29 |