| NPI | 1700221777 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103K00000X Behavior Analyst (Licence: GA 11622943) |
| Additional Taxonomies | 252Y00000X Early Intervention Provider Agency (Licence: NY 372809091) |
| Enumeration Date | 2013-05-05 |
| Last Update Date | 2021-08-04 |