| NPI | 1114415684 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: MI 6451023183) |
| Additional Taxonomies | 225800000X Recreation Therapist |
| Enumeration Date | 2018-04-30 |
| Last Update Date | 2023-10-10 |