| NPI | 1609414325 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 106S00000X Behavior Technician (Licence: RBT-20-127863) |
| Additional Taxonomies | 225100000X Physical Therapist |
| Enumeration Date | 2019-12-12 |
| Last Update Date | 2026-06-01 |