| NPI | 1639672215 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist, (Licence: AZ TSLP15360) |
| Additional Taxonomies | 106S00000X Behavior Technician (Licence: CA 17-45269) |
| Enumeration Date | 2018-03-09 |
| Last Update Date | 2024-09-10 |