| NPI | 1629399795 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103K00000X Behavior Analyst (Licence: GA 1-18-33584) |
| Additional Taxonomies | 251C00000X Day Training, Developmentally Disabled Services |
| 251S00000X | |
| 252Y00000X Early Intervention Provider Agency | |
| Enumeration Date | 2010-06-11 |
| Last Update Date | 2021-12-21 |