| NPI | 1609352145 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 106S00000X Behavior Technician (Licence: FL 19-80272) |
| Additional Taxonomies | 222Q00000X Developmental Therapist |
| Enumeration Date | 2018-07-18 |
| Last Update Date | 2019-10-08 |