NPI | 1609484021 |
---|---|
Former Name | KIARA DANIELLE DE JESUS |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 235Z00000X Speech-Language Pathologist, |
Additional Taxonomies | 106S00000X Behavior Technician (Licence: OH RBT-20-126331) |
Enumeration Date | 2020-07-22 |
Last Update Date | 2024-04-01 |