| NPI | 1730555467 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 106S00000X Behavior Technician |
| Additional Taxonomies | 101YM0800X Counselor Mental Health (Licence: MI 6301017105) |
| 103TC0700X Psychologist Clinical (Licence: MI 6301017105) | |
| 247200000X Technician, Other | |
| Enumeration Date | 2015-08-17 |
| Last Update Date | 2024-02-20 |