| NPI | 1205679842 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 106S00000X Behavior Technician (Licence: FL RBT-26-527385) |
| Additional Taxonomies | 124Q00000X Dental Hygienist (Licence: FL DH33325) |
| Enumeration Date | 2024-06-13 |
| Last Update Date | 2026-04-06 |