| NPI | 1174082044 |
|---|---|
| Former Name | IVY CAROLYN WOODRUFF |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 106E00000X Assistant Behavior Analyst (Licence: FL 0-21-12822) |
| Additional Taxonomies | 106S00000X Behavior Technician (Licence: RBT-17-43953) |
| Enumeration Date | 2019-03-19 |
| Last Update Date | 2023-08-18 |