| NPI | 1538693593 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103K00000X Behavior Analyst (Licence: MO 2017010137) |
| Additional Taxonomies | 251S00000X Community/Behavioral Health (Licence: MO 2017010137) |
| Enumeration Date | 2017-04-17 |
| Last Update Date | 2017-12-11 |