| NPI | 1013428390 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 224Z00000X Occupational Therapy Assistant (Licence: MI 5202008746) |
| Additional Taxonomies | 106S00000X Behavior Technician |
| Enumeration Date | 2017-10-13 |
| Last Update Date | 2023-07-11 |