| NPI | 1912423955 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist, (Licence: FL SZ8687) |
| Additional Taxonomies | 106S00000X Behavior Technician (Licence: NM RBT-16-17932) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2017-08-22 |
| Last Update Date | 2018-08-02 |