| NPI | 1336700509 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 106S00000X Behavior Technician (Licence: 19-89931) | 
| Additional Taxonomies | 222Q00000X Developmental Therapist | 
| Enumeration Date | 2019-06-27 | 
| Last Update Date | 2023-02-23 |