| NPI | 1629692009 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist, (Licence: FL 21988) |
| Additional Taxonomies | 106S00000X Behavior Technician |
| Enumeration Date | 2020-06-02 |
| Last Update Date | 2026-01-29 |