| NPI | 1962164178 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 106S00000X Behavior Technician (Licence: FL rbt24324167) |
| Additional Taxonomies | 225700000X Massage Therapist (Licence: FL MA95922) |
| Enumeration Date | 2021-10-06 |
| Last Update Date | 2026-03-09 |