| NPI | 1639842057 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program |
| Additional Taxonomies | 106S00000X Behavior Technician (Licence: MO RBT-21-176415) |
| Enumeration Date | 2021-07-30 |
| Last Update Date | 2026-04-06 |