| NPI | 1285107177 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103K00000X Behavior Analyst (Licence: MA 2022-385-MH-B1-APP) |
| Additional Taxonomies | 222Q00000X Developmental Therapist |
| Enumeration Date | 2019-01-03 |
| Last Update Date | 2022-12-09 |