| NPI | 1760015291 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 106S00000X Behavior Technician (Licence: FL RBT24324173) |
| Additional Taxonomies | 225700000X Massage Therapist (Licence: MA93671) |
| Enumeration Date | 2020-02-12 |
| Last Update Date | 2026-03-26 |