| NPI | 1962772772 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 106S00000X Behavior Technician (Licence: FL RBT-20-121527) |
| Additional Taxonomies | 225700000X Massage Therapist (Licence: FL MA63392) |
| Enumeration Date | 2012-01-10 |
| Last Update Date | 2020-06-09 |