| NPI | 1235517699 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103K00000X Behavior Analyst (Licence: MA 1-18-32752) |
| Additional Taxonomies | 222Q00000X Developmental Therapist |
| Enumeration Date | 2015-05-18 |
| Last Update Date | 2022-11-29 |