| NPI | 1316453699 |
|---|---|
| Entity Type | Individual |
| Gender | N/A |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225A00000X Music Therapist (Licence: 13586) |
| Additional Taxonomies | 106S00000X Behavior Technician (Licence: RBT-15-09756) |
| 106S00000X Behavior Technician (Licence: RBT-17-38877) | |
| Enumeration Date | 2017-12-21 |
| Last Update Date | 2021-09-13 |