| NPI | 1801176409 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 106S00000X Behavior Technician (Licence: FL RBT-20-120430) |
| Additional Taxonomies | 225700000X Massage Therapist (Licence: FL MA63211) |
| Enumeration Date | 2011-08-26 |
| Last Update Date | 2021-03-10 |