| NPI | 1336030162 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist, (Licence: LA 9828) | 
| Additional Taxonomies | 106S00000X Behavior Technician | 
| Enumeration Date | 2025-07-10 | 
| Last Update Date | 2025-07-18 |