| NPI | 1255858692 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 106S00000X Behavior Technician (Licence: UT RBT-17-36321) |
| Additional Taxonomies | 175T00000X Peer Specialist |
| Enumeration Date | 2017-08-25 |
| Last Update Date | 2022-07-21 |