| NPI | 1104475276 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist, (Licence: MI 7152000076) |
| Additional Taxonomies | 106S00000X Behavior Technician |
| Enumeration Date | 2019-09-10 |
| Last Update Date | 2022-03-22 |