| NPI | 1629630991 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103K00000X Behavior Analyst (Licence: MA LABA10000906) |
| Additional Taxonomies | 222Q00000X Developmental Therapist |
| Enumeration Date | 2019-07-08 |
| Last Update Date | 2024-04-26 |