| NPI | 1689213621 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 163WP0809X Registered Nurse Psychiatric/Mental Health, Adult (Licence: MI 4704371853) |
| Additional Taxonomies | 106S00000X Behavior Technician |
| Enumeration Date | 2019-12-21 |
| Last Update Date | 2024-02-20 |