| NPI | 1629422761 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 222Q00000X Developmental Therapist |
| Additional Taxonomies | 106S00000X Behavior Technician |
| 247200000X Technician, Other | |
| 252Y00000X Early Intervention Provider Agency | |
| Enumeration Date | 2016-04-14 |
| Last Update Date | 2023-03-08 |