| NPI | 1497862932 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist, (Licence: FL SA8179) | 
| Additional Taxonomies | 103K00000X Behavior Analyst (Licence: FL 1-14-17381) | 
| Enumeration Date | 2006-08-23 | 
| Last Update Date | 2016-05-27 |