| NPI | 1184124638 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC1900X Psychologist, Counseling (Licence: MI 6352000466) |
| Additional Taxonomies | 106S00000X Behavior Technician |
| Enumeration Date | 2018-02-20 |
| Last Update Date | 2021-01-20 |