| NPI | 1194252247 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103K00000X Behavior Analyst (Licence: MA 1-22-58286) |
| Additional Taxonomies | 222Q00000X Developmental Therapist |
| Enumeration Date | 2017-05-19 |
| Last Update Date | 2022-04-04 |