| NPI | 1609183706 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 106S00000X Behavior Technician (Licence: FL 19-74990) |
| Additional Taxonomies | 224Z00000X Occupational Therapy Assistant (Licence: NY 0067941) |
| Enumeration Date | 2010-09-10 |
| Last Update Date | 2021-06-04 |