| NPI | 1609483627 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 224Z00000X Occupational Therapy Assistant (Licence: FL 16668) |
| Additional Taxonomies | 106S00000X Behavior Technician (Licence: GA RBT-20-135036) |
| Enumeration Date | 2020-09-24 |
| Last Update Date | 2022-05-04 |