| NPI | 1134786866 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103K00000X Behavior Analyst (Licence: FL 1-24-74346) |
| Additional Taxonomies | 164W00000X Licensed Practical Nurse (Licence: MI 4703121218) |
| Enumeration Date | 2019-05-29 |
| Last Update Date | 2024-09-06 |