| NPI | 1669029435 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101Y00000X Counselor (Licence: MI 6451023979) |
| Additional Taxonomies | 247200000X Technician, Other |
| 106S00000X Behavior Technician | |
| Enumeration Date | 2019-08-26 |
| Last Update Date | 2026-01-20 |