| NPI | 1194376046 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 224Z00000X Occupational Therapy Assistant (Licence: MN 202444) |
| Additional Taxonomies | 106S00000X Behavior Technician (Licence: MN 202444) |
| Enumeration Date | 2019-09-23 |
| Last Update Date | 2021-09-09 |