| NPI | 1417423401 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program |
| Additional Taxonomies | 106S00000X Behavior Technician (Licence: CA 18-67198) |
| Enumeration Date | 2018-10-17 |
| Last Update Date | 2023-05-01 |