| NPI | 1558636050 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103K00000X Behavior Analyst (Licence: WI 12-140) |
| Additional Taxonomies | 235Z00000X Speech-Language Pathologist, (Licence: WI 562-154) |
| Enumeration Date | 2012-03-15 |
| Last Update Date | 2012-03-15 |