| NPI | 1578100459 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist, (Licence: LA 10025) |
| Additional Taxonomies | 106S00000X Behavior Technician |
| Enumeration Date | 2019-12-10 |
| Last Update Date | 2026-02-04 |