| NPI | 1215466602 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103K00000X Behavior Analyst (Licence: MA 11833158) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| 222Q00000X Developmental Therapist | |
| Enumeration Date | 2017-06-08 |
| Last Update Date | 2020-03-25 |