| NPI | 1689147860 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist,   (Licence: AZ SLP13256)  | 
| Additional Taxonomies | 106S00000X Behavior Technician | 
| Enumeration Date | 2019-01-09 | 
| Last Update Date | 2022-07-13 |