| NPI | 1215491204 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103K00000X Behavior Analyst (Licence: FL 1-19-37845) |
| Additional Taxonomies | 247200000X Technician, Other (Licence: PA 1854394) |
| Enumeration Date | 2019-01-24 |
| Last Update Date | 2020-09-13 |