| NPI | 1598276776 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 252Y00000X Early Intervention Provider Agency |
| Additional Taxonomies | 252Y00000X Early Intervention Provider Agency (Licence: MI N100765793873) |
| 103K00000X Behavior Analyst (Licence: BACB501853) | |
| Enumeration Date | 2017-10-16 |
| Last Update Date | 2024-02-08 |