| NPI | 1952806341 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 106S00000X Behavior Technician (Licence: FL RBT-1864647) |
| Additional Taxonomies | 225200000X Physical Therapy Assistant |
| 261Q00000X (Licence: FL PTA) | |
| Enumeration Date | 2018-03-27 |
| Last Update Date | 2022-03-28 |