| NPI | 1386143451 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 106S00000X Behavior Technician (Licence: 17-44758)  | 
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: FL 11031438)  | 
| Enumeration Date | 2018-02-05 | 
| Last Update Date | 2025-01-21 |