| NPI | 1912268608 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103K00000X Behavior Analyst (Licence: LBA0000000423) |
| Additional Taxonomies | 235Z00000X Speech-Language Pathologist, |
| 247200000X | |
| 2080P0006X Pediatrics, Developmental - Behavioral Pediatrics (Licence: TN LBA0000000423) | |
| Enumeration Date | 2012-05-30 |
| Last Update Date | 2019-07-29 |