| NPI | 1720557887 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor Professional (Licence: MI 6451024261) |
| Additional Taxonomies | 106S00000X Behavior Technician |
| Enumeration Date | 2018-11-19 |
| Last Update Date | 2025-06-18 |