NPI | 1306405683 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 235Z00000X Speech-Language Pathologist, (Licence: FL SZ12581) |
Additional Taxonomies | 106S00000X Behavior Technician (Licence: FL RBT-19-86198) |
Enumeration Date | 2019-06-10 |
Last Update Date | 2025-04-30 |