| NPI | 1104434885 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225X00000X Occupational Therapist (Licence: MI 5201013674) |
| Additional Taxonomies | 106S00000X Behavior Technician |
| Enumeration Date | 2020-07-17 |
| Last Update Date | 2026-04-03 |