| NPI | 1578080453 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 106S00000X Behavior Technician |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: MI 6451017801) |
| Enumeration Date | 2017-08-23 |
| Last Update Date | 2022-07-21 |