| NPI | 1912540394 |
|---|---|
| Entity Type | Individual |
| Gender | N/A |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225A00000X Music Therapist (Licence: 11807) |
| Additional Taxonomies | 106S00000X Behavior Technician (Licence: RBT-15-03563) |
| 225A00000X Music Therapist | |
| Enumeration Date | 2019-10-18 |
| Last Update Date | 2021-09-14 |