| NPI | 1902231715 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103K00000X Behavior Analyst (Licence: FL 12153588) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: PR 004859) |
| 222Q00000X Developmental Therapist | |
| 2355S0801X Specialist/Technologist, Speech-Language Assistant | |
| Enumeration Date | 2013-09-11 |
| Last Update Date | 2021-10-04 |