| NPI | 1215598610 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103K00000X Behavior Analyst (Licence: MA LABA10001192) |
| Additional Taxonomies | 222Q00000X Developmental Therapist |
| Enumeration Date | 2019-06-26 |
| Last Update Date | 2024-11-07 |