| NPI | 1053087296 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: MI 6851115845) |
| Additional Taxonomies | 106S00000X Behavior Technician |
| Enumeration Date | 2021-08-18 |
| Last Update Date | 2025-03-24 |