| NPI | 1164062931 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 171M00000X Case Manager/Care Coordinator (Licence: MI 6852092002) |
| Additional Taxonomies | 106S00000X Behavior Technician |
| Enumeration Date | 2020-01-09 |
| Last Update Date | 2022-04-27 |