| NPI | 1649871922 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 106S00000X Behavior Technician (Licence: CA RBT-20-140744) |
| Additional Taxonomies | 222Q00000X Developmental Therapist |
| Enumeration Date | 2020-11-04 |
| Last Update Date | 2021-11-02 |