| NPI | 1366947814 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 104100000X Social Worker (Licence: MI 6801103372) |
| Additional Taxonomies | 106S00000X Behavior Technician |
| 251S00000X | |
| Enumeration Date | 2018-03-27 |
| Last Update Date | 2018-12-17 |