| NPI | 1679889463 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist, (Licence: ME SP1672) |
| Additional Taxonomies | 106S00000X Behavior Technician (Licence: CO RBT-20-125845) |
| Enumeration Date | 2010-08-31 |
| Last Update Date | 2021-09-23 |