| NPI | 1417492851 |
|---|---|
| Former Name | MICHAL DEDRICK |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101Y00000X Counselor (Licence: OR C7904) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: OR R7792) |
| 103K00000X Behavior Analyst | |
| Enumeration Date | 2016-12-20 |
| Last Update Date | 2024-03-06 |