| NPI | 1356754535 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103K00000X Behavior Analyst (Licence: 1-15-20651) |
| Additional Taxonomies | 235Z00000X Speech-Language Pathologist, (Licence: WA LL 00004760) |
| Enumeration Date | 2014-06-05 |
| Last Update Date | 2016-06-29 |