| NPI | 1619451614 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225X00000X Occupational Therapist (Licence: MO 2022010049) |
| Additional Taxonomies | 106S00000X Behavior Technician (Licence: MO RBT-17-41531) |
| Enumeration Date | 2018-09-17 |
| Last Update Date | 2022-05-13 |