| NPI | 1316398308 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 106S00000X Behavior Technician (Licence: LA RBT-17-37500) |
| Additional Taxonomies | 222Q00000X Developmental Therapist |
| Enumeration Date | 2016-06-30 |
| Last Update Date | 2018-07-30 |