| NPI | 1164088639 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 171M00000X Case Manager/Care Coordinator |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: MI 6851115933) |
| 106S00000X Behavior Technician | |
| Enumeration Date | 2019-05-10 |
| Last Update Date | 2023-01-19 |