NPI | 1093265134 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: MI 6801098235) |
Additional Taxonomies | 106S00000X Behavior Technician |
Enumeration Date | 2016-10-13 |
Last Update Date | 2020-01-25 |