| NPI | 1295050573 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 106S00000X Behavior Technician (Licence: FL rbt-24-399991)  | 
| Additional Taxonomies | 225700000X Massage Therapist (Licence: FL MA58749)  | 
| Enumeration Date | 2010-03-30 | 
| Last Update Date | 2025-01-05 |