| NPI | 1265997894 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 104100000X Social Worker (Licence: MI 6801116754) |
| Additional Taxonomies | 106S00000X Behavior Technician (Licence: 19-77683) |
| Enumeration Date | 2019-02-07 |
| Last Update Date | 2024-01-03 |