| NPI | 1669153052 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225200000X Physical Therapy Assistant (Licence: KS T-06400) |
| Additional Taxonomies | 103K00000X Behavior Analyst |
| Enumeration Date | 2023-07-27 |
| Last Update Date | 2025-09-16 |