| NPI | 1962771477 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: FL PT32623) |
| Additional Taxonomies | 106E00000X Assistant Behavior Analyst (Licence: FL 0-14-5808) |
| Enumeration Date | 2011-12-29 |
| Last Update Date | 2019-11-17 |