| NPI | 1235677014 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist, (Licence: MA 77633-SP-SL) |
| Additional Taxonomies | 106S00000X Behavior Technician |
| Enumeration Date | 2017-02-01 |
| Last Update Date | 2020-06-16 |