| NPI | 1639605157 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist, (Licence: MI 7101005886) |
| Additional Taxonomies | 106S00000X Behavior Technician |
| Enumeration Date | 2017-05-03 |
| Last Update Date | 2019-01-24 |