| NPI | 1740735679 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225200000X Physical Therapy Assistant (Licence: FL 26431) |
| Additional Taxonomies | 106S00000X Behavior Technician (Licence: FL RBT-22-246384) |
| Enumeration Date | 2016-08-21 |
| Last Update Date | 2023-02-02 |