| NPI | 1154794311 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker Clinical (Licence: MI 6801098360) |
| Additional Taxonomies | 103K00000X Behavior Analyst (Licence: MI 24700000X) |
| Enumeration Date | 2015-11-09 |
| Last Update Date | 2018-06-12 |