| NPI | 1033398581 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TM1800X Psychologist, Intellectual & Developmental Disabilities (Licence: MI 6301008405) |
| Additional Taxonomies | 103K00000X Behavior Analyst (Licence: MI 1-14-15612) |
| 103TB0200X Psychologist, Cognitive & Behavioral (Licence: MI 6301008405) | |
| Enumeration Date | 2007-11-01 |
| Last Update Date | 2020-04-17 |