| NPI | 1114446705 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: MI 6801082528) |
| Additional Taxonomies | 104100000X Social Worker |
| 106S00000X Behavior Technician | |
| Enumeration Date | 2017-09-14 |
| Last Update Date | 2025-05-12 |