| NPI | 1982239729 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 163W00000X Registered Nurse (Licence: FL 9594682) |
| Additional Taxonomies | 106S00000X Behavior Technician (Licence: FL RBT-20-111425) |
| Enumeration Date | 2020-03-11 |
| Last Update Date | 2026-06-08 |