NPI | 1972076610 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 235Z00000X Speech-Language Pathologist, (Licence: CA 38156) |
Additional Taxonomies | 106S00000X Behavior Technician (Licence: CA RBT-19-75004) |
Enumeration Date | 2019-01-04 |
Last Update Date | 2025-02-03 |