| NPI | 1659838860 |
|---|---|
| Former Name | SAMANTHA DYKEMA |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 224Z00000X Occupational Therapy Assistant (Licence: MI 5202008675) |
| Additional Taxonomies | 106S00000X Behavior Technician |
| Enumeration Date | 2019-02-23 |
| Last Update Date | 2021-10-28 |