| NPI | 1710763644 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: MI 6851118500) |
| Additional Taxonomies | 106S00000X Behavior Technician |
| Enumeration Date | 2023-09-06 |
| Last Update Date | 2025-06-25 |