| NPI | 1235773557 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103K00000X Behavior Analyst (Licence: 38938700) |
| Additional Taxonomies | 251S00000X Community/Behavioral Health (Licence: LA 38938700) |
| Enumeration Date | 2019-10-30 |
| Last Update Date | 2019-10-31 |