| NPI | 1700241080 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103K00000X Behavior Analyst (Licence: FL 1-17-27911) |
| Additional Taxonomies | 222Q00000X Developmental Therapist |
| Enumeration Date | 2015-12-30 |
| Last Update Date | 2017-11-03 |