| NPI | 1316604499 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: MI 6451023900) |
| Additional Taxonomies | 106S00000X Behavior Technician |
| Enumeration Date | 2021-11-23 |
| Last Update Date | 2024-10-15 |