| NPI | 1215430707 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NC 0010-15322) |
| Additional Taxonomies | 106S00000X Behavior Technician |
| Enumeration Date | 2018-03-12 |
| Last Update Date | 2025-09-15 |