| NPI | 1750841599 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 251S00000X Community/Behavioral Health |
| Additional Taxonomies | 106S00000X Behavior Technician (Licence: GA RBT-19-74736) |
| Enumeration Date | 2019-03-20 |
| Last Update Date | 2020-02-04 |