| NPI | 1699336693 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: MI 4101007649) |
| Additional Taxonomies | 106S00000X Behavior Technician (Licence: MI 4101007649) |
| Enumeration Date | 2019-06-21 |
| Last Update Date | 2026-06-01 |