| NPI | 1831756071 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103K00000X Behavior Analyst (Licence: NJ 18KT00761500) |
| Additional Taxonomies | 225700000X Massage Therapist (Licence: NJ 18KT00761500) |
| 252Y00000X Early Intervention Provider Agency | |
| Enumeration Date | 2019-05-23 |
| Last Update Date | 2019-05-23 |