| NPI | 1457134918 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: MI 6851121524) |
| Additional Taxonomies | 106S00000X Behavior Technician (Licence: MI 6851121524) |
| Enumeration Date | 2023-08-17 |
| Last Update Date | 2026-06-17 |