| NPI | 1821649823 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist, (Licence: FL SA22621) |
| Additional Taxonomies | 106S00000X Behavior Technician (Licence: FL BACB-19-188940) |
| Enumeration Date | 2019-09-23 |
| Last Update Date | 2026-02-06 |