| NPI | 1912565805 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist, (Licence: MO 2022029669) |
| Additional Taxonomies | 106S00000X Behavior Technician (Licence: IL RBT-19-79762) |
| Enumeration Date | 2019-06-05 |
| Last Update Date | 2023-05-04 |