| NPI | 1588273981 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: MI 6451025151) |
| Additional Taxonomies | 106S00000X Behavior Technician |
| Enumeration Date | 2020-07-31 |
| Last Update Date | 2026-07-03 |