| NPI | 1801468285 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 106S00000X Behavior Technician |
| Additional Taxonomies | 251S00000X Community/Behavioral Health (Licence: MN 247200000X) |
| Enumeration Date | 2021-07-14 |
| Last Update Date | 2022-04-20 |