NPI | 1609310713 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: MI 6401014353) |
Additional Taxonomies | 101Y00000X Counselor (Licence: 6301014353) |
103K00000X Behavior Analyst (Licence: MI 1-17-25333) | |
Enumeration Date | 2016-12-08 |
Last Update Date | 2021-05-05 |