NPI | 1063067619 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: MI 6851115372) |
Additional Taxonomies | 106S00000X Behavior Technician |
Enumeration Date | 2019-08-09 |
Last Update Date | 2022-08-08 |