| NPI | 1558897520 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: MI 6801107556) |
| Additional Taxonomies | 222Q00000X Developmental Therapist |
| 106S00000X Behavior Technician | |
| Enumeration Date | 2017-05-11 |
| Last Update Date | 2020-07-31 |