| NPI | 1629696851 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 163W00000X Registered Nurse (Licence: FL RN9648509) |
| Additional Taxonomies | 106S00000X Behavior Technician (Licence: FL RBT-20-126293) |
| Enumeration Date | 2020-07-14 |
| Last Update Date | 2024-05-28 |