NPI | 1588160287 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: MI 6401222267) |
Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: MI 6401014688) |
106S00000X Behavior Technician | |
Enumeration Date | 2018-04-02 |
Last Update Date | 2024-11-01 |