| NPI | 1821685058 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225200000X Physical Therapy Assistant (Licence: GA CPO13255A) |
| Additional Taxonomies | 106S00000X Behavior Technician (Licence: GA RBT-20-149219) |
| Enumeration Date | 2020-12-22 |
| Last Update Date | 2022-09-07 |