| NPI | 1558963082 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103K00000X Behavior Analyst (Licence: MI 7401002203) |
| Additional Taxonomies | 101YM0800X Counselor Mental Health |
| 106S00000X Behavior Technician | |
| Enumeration Date | 2020-11-10 |
| Last Update Date | 2023-09-19 |