| NPI | 1538552807 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 252Y00000X Early Intervention Provider Agency |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: MI 6401222462) |
| 101YS0200X Counselor, School (Licence: MI 6401222462) | |
| Enumeration Date | 2015-03-11 |
| Last Update Date | 2026-04-15 |