| NPI | 1780250670 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist, (Licence: MN 528920) |
| Additional Taxonomies | 106S00000X Behavior Technician |
| Enumeration Date | 2021-06-01 |
| Last Update Date | 2025-07-24 |