| NPI | 1073160834 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 163WP0808X Registered Nurse, Psych/Mental Health (Licence: MI 4704411728) |
| Additional Taxonomies | 106S00000X Behavior Technician |
| Enumeration Date | 2019-08-26 |
| Last Update Date | 2024-04-16 |