| NPI | 1245753631 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: MI 6851102602) |
| Additional Taxonomies | 106S00000X Behavior Technician |
| Enumeration Date | 2017-07-18 |
| Last Update Date | 2022-09-23 |