| NPI | 1528583440 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225X00000X Occupational Therapist (Licence: GA OT008168) |
| Additional Taxonomies | 106S00000X Behavior Technician (Licence: RBT-15-07966) |
| Enumeration Date | 2017-08-11 |
| Last Update Date | 2022-02-01 |