| NPI | 1205304250 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225X00000X Occupational Therapist (Licence: MI 5201012769) |
| Additional Taxonomies | 106S00000X Behavior Technician |
| Enumeration Date | 2018-11-07 |
| Last Update Date | 2024-06-27 |