| NPI | 1720693849 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103K00000X Behavior Analyst (Licence: MA 1-20-40931) |
| Additional Taxonomies | 103K00000X Behavior Analyst (Licence: MA 3111) |
| Enumeration Date | 2020-09-15 |
| Last Update Date | 2022-07-26 |