| NPI | 1508383696 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: MI 6801102807) |
| Additional Taxonomies | 106S00000X Behavior Technician |
| Enumeration Date | 2017-08-29 |
| Last Update Date | 2018-08-30 |