| NPI | 1912598442 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: PA BH005242) |
| Additional Taxonomies | 106S00000X Behavior Technician |
| Enumeration Date | 2021-01-28 |
| Last Update Date | 2021-02-09 |