| NPI | 1619613296 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: MI 6851117493) |
| Additional Taxonomies | 106S00000X Behavior Technician |
| Enumeration Date | 2022-05-06 |
| Last Update Date | 2023-12-11 |