| NPI | 1255576765 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 320600000X Residential Treatment Facility, Intellectual and/or Developmental Disabilities (Licence: MI AS2504124845) |
| Additional Taxonomies | 106S00000X Behavior Technician (Licence: MI bcba1349277) |
| Enumeration Date | 2008-12-11 |
| Last Update Date | 2026-04-14 |