| NPI | 1053704809 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 106S00000X Behavior Technician |
| Additional Taxonomies | 1041C0700X Social Worker Clinical (Licence: MI 6801097763) |
| Enumeration Date | 2015-03-17 |
| Last Update Date | 2020-06-04 |