| NPI | 1619591203 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist, (Licence: MN 10537) |
| Additional Taxonomies | 106S00000X Behavior Technician |
| Enumeration Date | 2020-05-30 |
| Last Update Date | 2021-05-04 |