| NPI | 1154866457 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 106S00000X Behavior Technician (Licence: MI RBT-19-105239) | 
| Additional Taxonomies | 106S00000X Behavior Technician | 
| Enumeration Date | 2016-12-23 | 
| Last Update Date | 2019-11-22 |