| NPI | 1508056714 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 3747P1801X Technician, Personal Care Attendant |
| Additional Taxonomies | 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: MI 6301014586) |
| Enumeration Date | 2007-07-25 |
| Last Update Date | 2017-03-07 |