| NPI | 1831804525 |
|---|---|
| Former Name | DIANE SIMONE ROSE |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 106S00000X Behavior Technician (Licence: GA RBT-23-252400) |
| Additional Taxonomies | 224Z00000X Occupational Therapy Assistant |
| Enumeration Date | 2023-01-18 |
| Last Update Date | 2023-01-18 |