| NPI | 1932494754 |
|---|---|
| Former Name | SAMANTHA BRODERICK |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103K00000X Behavior Analyst |
| Additional Taxonomies | 103K00000X Behavior Analyst (Licence: FL 1-16-23336) |
| Enumeration Date | 2011-06-09 |
| Last Update Date | 2022-11-04 |