| NPI | 1861857468 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 106S00000X Behavior Technician (Licence: TX RBT-21-157071) |
| Additional Taxonomies | 225700000X Massage Therapist (Licence: WA MA60597648) |
| Enumeration Date | 2015-12-23 |
| Last Update Date | 2021-02-23 |