| NPI | 1407277684 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103K00000X Behavior Analyst (Licence: IL 1-17-25487) |
| Additional Taxonomies | 222Q00000X Developmental Therapist |
| Enumeration Date | 2013-12-14 |
| Last Update Date | 2021-06-03 |