| NPI | 1609647254 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 106S00000X Behavior Technician |
| Additional Taxonomies | 225700000X Massage Therapist (Licence: VA 0019015414) |
| Enumeration Date | 2024-01-12 |
| Last Update Date | 2025-01-10 |