| NPI | 1679863237 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103K00000X Behavior Analyst (Licence: FL 11410241) |
| Additional Taxonomies | 222Q00000X Developmental Therapist |
| 251S00000X Community/Behavioral Health (Licence: FL 11410241) | |
| Enumeration Date | 2011-04-15 |
| Last Update Date | 2024-01-17 |