| NPI | 1972990158 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program |
| Additional Taxonomies | 103K00000X Behavior Analyst (Licence: MA 103K00000K) |
| Enumeration Date | 2015-04-24 |
| Last Update Date | 2015-05-29 |