| NPI | 1447857156 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 106S00000X Behavior Technician |
| Additional Taxonomies | 251S00000X Community/Behavioral Health (Licence: MI 106S00000X) |
| Enumeration Date | 2020-10-06 |
| Last Update Date | 2022-08-12 |