| NPI | 1760835706 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 252Y00000X Early Intervention Provider Agency |
| Additional Taxonomies | 106S00000X Behavior Technician (Licence: OH RBT-18-6930) |
| Enumeration Date | 2016-07-14 |
| Last Update Date | 2019-11-26 |