| NPI | 1811292998 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 222Q00000X Developmental Therapist |
| Additional Taxonomies | 103K00000X Behavior Analyst (Licence: 1-09-5651) |
| 1041C0700X Social Worker, Clinical (Licence: UT 5633817-3501) | |
| Enumeration Date | 2011-01-20 |
| Last Update Date | 2011-01-20 |