| NPI | 1962790667 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 261QD1600X Clinic/Center, Developmental Disabilities |
| Additional Taxonomies | 103K00000X Behavior Analyst (Licence: FL 1010726) |
| Enumeration Date | 2011-07-14 |
| Last Update Date | 2022-07-21 |