| NPI | 1336794932 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103K00000X Behavior Analyst (Licence: MI BACB520256) |
| Additional Taxonomies | 247200000X Technician, Other |
| 101YM0800X Counselor, Mental Health | |
| Enumeration Date | 2019-08-09 |
| Last Update Date | 2021-10-01 |