| NPI | 1306951983 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103K00000X Behavior Analyst (Licence: 1-09-5068) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: GA RN 141187 NP) |
| Enumeration Date | 2006-08-21 |
| Last Update Date | 2009-05-24 |