| NPI | 1720565765 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist, (Licence: MI 7151013473) |
| Additional Taxonomies | 106S00000X Behavior Technician |
| Enumeration Date | 2018-07-23 |
| Last Update Date | 2021-01-06 |