| NPI | 1528955044 |
|---|---|
| Entity Type | Individual |
| Gender | N/A |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2355S0801X Specialist/Technologist, Speech-Language Assistant (Licence: OK SLPA456) |
| Additional Taxonomies | 106S00000X Behavior Technician (Licence: OK RBT-25-445530) |
| Enumeration Date | 2025-06-18 |
| Last Update Date | 2026-07-24 |