| NPI | 1700480894 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 106S00000X Behavior Technician (Licence: FL 20-132307) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: FL 9459736) |
| Enumeration Date | 2020-11-30 |
| Last Update Date | 2020-12-28 |