| NPI | 1962111062 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist, (Licence: IL 242.008104) |
| Additional Taxonomies | 106S00000X Behavior Technician (Licence: NY 335411913) |
| Enumeration Date | 2022-11-17 |
| Last Update Date | 2025-04-25 |