| NPI | 1164972253 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: MI 6801121651) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: MI 6851115980) |
| 106S00000X Behavior Technician | |
| Enumeration Date | 2016-10-12 |
| Last Update Date | 2026-02-03 |