| NPI | 1639696909 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist, (Licence: FL SZ10026) |
| Additional Taxonomies | 106S00000X Behavior Technician |
| 252Y00000X Early Intervention Provider Agency | |
| Enumeration Date | 2017-08-27 |
| Last Update Date | 2021-05-20 |