| NPI | 1679195119 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 106S00000X Behavior Technician (Licence: FL RBT-20-5689-210864) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: FL 11031699) |
| Enumeration Date | 2020-05-06 |
| Last Update Date | 2024-07-14 |