| NPI | 1548956345 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program (Licence: FL IMH26938) |
| Additional Taxonomies | 106S00000X Behavior Technician |
| Enumeration Date | 2023-04-13 |
| Last Update Date | 2025-02-25 |