NPI | 1194125021 |
---|---|
Former Name | HEATHER MARIE VICENTY |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 225A00000X Music Therapist (Licence: 13275) |
Additional Taxonomies | 106S00000X Behavior Technician (Licence: RBT-15-05327) |
Enumeration Date | 2014-08-28 |
Last Update Date | 2022-01-22 |