| NPI | 1912579517 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 106S00000X Behavior Technician (Licence: NC 2013) |
| Additional Taxonomies | 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: NC 2013) |
| Enumeration Date | 2021-07-13 |
| Last Update Date | 2021-07-13 |