| NPI | 1578438313 |
|---|---|
| Entity Type | Individual |
| Gender | N/A |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2355S0801X Specialist/Technologist, Speech-Language Assistant (Licence: CA 10303) |
| Additional Taxonomies | 103K00000X Behavior Analyst |
| Enumeration Date | 2025-10-10 |
| Last Update Date | 2026-08-28 |