| NPI | 1942800511 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 106S00000X Behavior Technician (Licence: RBT-20-139096) |
| Additional Taxonomies | 222Q00000X Developmental Therapist |
| Enumeration Date | 2020-10-31 |
| Last Update Date | 2023-04-13 |