| NPI | 1649700576 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103K00000X Behavior Analyst (Licence: MA 1-21-54258) |
| Additional Taxonomies | 222Q00000X Developmental Therapist |
| Enumeration Date | 2017-06-13 |
| Last Update Date | 2023-06-30 |