| NPI | 1417592155 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225X00000X Occupational Therapist (Licence: MN 107319) |
| Additional Taxonomies | 106S00000X Behavior Technician |
| 2255A2300X Specialist/Technologist, Athletic Trainer | |
| Enumeration Date | 2019-11-15 |
| Last Update Date | 2023-11-02 |