| NPI | 1669900122 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 171M00000X Case Manager/Care Coordinator (Licence: MI 6802089529) |
| Additional Taxonomies | 106S00000X Behavior Technician |
| Enumeration Date | 2017-05-30 |
| Last Update Date | 2023-06-12 |