NPI | 1811168172 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 103K00000X Behavior Analyst (Licence: NM 1-03-1109) |
Additional Taxonomies | 101Y00000X Counselor |
101Y00000X Counselor (Licence: CERT#1-03-1109 BCBA) | |
225700000X Massage Therapist (Licence: NM 6162) | |
Enumeration Date | 2008-03-14 |
Last Update Date | 2020-11-09 |