| NPI | 1164948832 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 106S00000X Behavior Technician (Licence: MI RBT-19-75277) |
| Additional Taxonomies | 175T00000X Peer Specialist |
| 106S00000X Behavior Technician | |
| Enumeration Date | 2017-08-15 |
| Last Update Date | 2022-09-27 |