| NPI | 1598258592 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103K00000X Behavior Analyst (Licence: 1-19-37562) |
| Additional Taxonomies | 222Q00000X Developmental Therapist |
| Enumeration Date | 2018-06-13 |
| Last Update Date | 2021-11-16 |