| NPI | 1528574472 |
|---|---|
| Former Name | JESSICA GONZALEZ |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 222Q00000X Developmental Therapist |
| Additional Taxonomies | 106S00000X Behavior Technician |
| Enumeration Date | 2017-12-14 |
| Last Update Date | 2019-01-02 |