| NPI | 1891203030 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 224Z00000X Occupational Therapy Assistant (Licence: CO OTA.0001558) |
| Additional Taxonomies | 106S00000X Behavior Technician |
| Enumeration Date | 2018-01-22 |
| Last Update Date | 2022-04-18 |