| NPI | 1194205104 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 103K00000X Behavior Analyst (Licence: MA 1-20-43035)  | 
| Additional Taxonomies | 106S00000X Behavior Technician | 
| Enumeration Date | 2018-08-19 | 
| Last Update Date | 2021-05-12 |