| NPI | 1396120028 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103K00000X Behavior Analyst (Licence: 1-15-18768) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: MI 6401014847) |
| Enumeration Date | 2015-07-23 |
| Last Update Date | 2017-03-03 |