| NPI | 1164949160 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 104100000X Social Worker (Licence: MI 6851114076APP21) |
| Additional Taxonomies | 104100000X Social Worker |
| 106S00000X Behavior Technician | |
| Enumeration Date | 2017-08-29 |
| Last Update Date | 2022-07-28 |