| NPI | 1699077503 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103K00000X Behavior Analyst (Licence: NC 2748) |
| Additional Taxonomies | 103K00000X Behavior Analyst (Licence: 1-16-21808) |
| 363AM0700X Physician Assistant Medical | |
| Enumeration Date | 2010-11-29 |
| Last Update Date | 2025-05-21 |