| NPI | 1144891490 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103K00000X Behavior Analyst (Licence: MI 1-24-72802) |
| Additional Taxonomies | 225800000X Recreation Therapist (Licence: MI 68925) |
| Enumeration Date | 2021-07-08 |
| Last Update Date | 2024-11-04 |