NPI | 1497275713 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: MI 6801114459) |
Additional Taxonomies | 106S00000X Behavior Technician |
Enumeration Date | 2017-06-27 |
Last Update Date | 2022-11-14 |