| NPI | 1912585670 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 106S00000X Behavior Technician (Licence: GA RBT-21-162400) |
| Additional Taxonomies | 222Q00000X Developmental Therapist |
| Enumeration Date | 2021-04-01 |
| Last Update Date | 2022-03-10 |