| NPI | 1912307711 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103K00000X Behavior Analyst (Licence: WI 214-140) |
| Additional Taxonomies | 104100000X Social Worker (Licence: WI 128554-121) |
| Enumeration Date | 2014-08-28 |
| Last Update Date | 2018-01-18 |