| NPI | 1487341590 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 106S00000X Behavior Technician (Licence: VA RBT-23-282325) |
| Additional Taxonomies | 225800000X Recreation Therapist (Licence: VA 86173) |
| Enumeration Date | 2023-04-19 |
| Last Update Date | 2025-11-18 |