NPI | 1528572567 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: MI 6851111223) |
Additional Taxonomies | 106S00000X Behavior Technician |
Enumeration Date | 2017-11-29 |
Last Update Date | 2021-12-25 |