| NPI | 1578111324 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist, (Licence: VA 2204001010) |
| Additional Taxonomies | 106S00000X Behavior Technician (Licence: VA A61461900) |
| Enumeration Date | 2019-08-26 |
| Last Update Date | 2022-08-25 |