| NPI | 1851596100 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103K00000X Behavior Analyst (Licence: NY 1-11-9021) |
| Additional Taxonomies | 164W00000X Licensed Practical Nurse (Licence: NY 2314371) |
| 174400000X Specialist (Licence: NY 708643) | |
| 251S00000X Community/Behavioral Health | |
| Enumeration Date | 2007-06-18 |
| Last Update Date | 2021-11-01 |