| NPI | 1497379432 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103K00000X Behavior Analyst (Licence: 1-20-43829) |
| Additional Taxonomies | 222Q00000X Developmental Therapist |
| Enumeration Date | 2020-06-05 |
| Last Update Date | 2020-09-07 |