| NPI | 1730588765 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: MI 6801104280) |
| Additional Taxonomies | 106S00000X Behavior Technician |
| 247200000X Technician, Other | |
| Enumeration Date | 2014-08-14 |
| Last Update Date | 2023-08-01 |