| NPI | 1699183202 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: 6801097110) |
| Additional Taxonomies | 103K00000X Behavior Analyst |
| 104100000X Social Worker (Licence: MI 6801097110) | |
| Enumeration Date | 2014-07-28 |
| Last Update Date | 2020-02-07 |