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 Clinic/Center (Licence: FL PTA) | |
Enumeration Date | 2018-03-27 |
Last Update Date | 2022-03-28 |