| NPI | 1003397266 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: MI 6401019803) |
| Additional Taxonomies | 103TC1900X Psychologist, Counseling (Licence: MI 6301017785) |
| 106S00000X Behavior Technician | |
| Enumeration Date | 2018-08-26 |
| Last Update Date | 2022-04-26 |