| NPI | 1548870801 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 224Z00000X Occupational Therapy Assistant (Licence: FL OTA19402)  | 
| Additional Taxonomies | 106S00000X Behavior Technician | 
| Enumeration Date | 2020-08-03 | 
| Last Update Date | 2023-06-08 |