| NPI | 1972261501 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist, (Licence: FL 12163) |
| Additional Taxonomies | 106S00000X Behavior Technician (Licence: FL RBT-20-121770) |
| Enumeration Date | 2021-12-01 |
| Last Update Date | 2024-09-19 |