| NPI | 1174962567 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 222Q00000X Developmental Therapist |
| Additional Taxonomies | 103K00000X Behavior Analyst |
| 2355S0801X Specialist/Technologist, Speech-Language Assistant (Licence: FL SI2002) | |
| Enumeration Date | 2013-06-18 |
| Last Update Date | 2019-05-12 |