| NPI | 1245749043 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: MI 6801119104) |
| Additional Taxonomies | 106S00000X Behavior Technician |
| 104100000X Social Worker (Licence: MI 6801102883) | |
| Enumeration Date | 2017-09-25 |
| Last Update Date | 2024-11-11 |