| NPI | 1346873973 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103K00000X Behavior Analyst (Licence: GA BACB112978) |
| Additional Taxonomies | 225200000X Physical Therapy Assistant (Licence: FL 29647) |
| Enumeration Date | 2020-02-21 |
| Last Update Date | 2026-06-25 |