| NPI | 1558908665 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 224Z00000X Occupational Therapy Assistant (Licence: SC 5310) |
| Additional Taxonomies | 106S00000X Behavior Technician |
| Enumeration Date | 2019-12-09 |
| Last Update Date | 2021-09-20 |