| NPI | 1053801357 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 171M00000X Case Manager/Care Coordinator |
| Additional Taxonomies | 106S00000X Behavior Technician (Licence: MI 17-43833) |
| Enumeration Date | 2018-05-14 |
| Last Update Date | 2026-02-18 |