| NPI | 1467702407 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: MI 6301015244) |
| Additional Taxonomies | 171M00000X Case Manager/Care Coordinator (Licence: MI 6301015244) |
| 103K00000X Behavior Analyst (Licence: MI 1-17-25043) | |
| Enumeration Date | 2012-09-18 |
| Last Update Date | 2017-04-04 |