NPI | 1558835025 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: MI 6801107680) |
Additional Taxonomies | 106S00000X Behavior Technician |
Enumeration Date | 2019-01-17 |
Last Update Date | 2021-06-23 |