| NPI | 1295178572 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 106S00000X Behavior Technician |
| Additional Taxonomies | 225800000X Recreation Therapist (Licence: MI 59593) |
| Enumeration Date | 2013-04-17 |
| Last Update Date | 2018-11-12 |