| NPI | 1740904788 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist, (Licence: MI 7101007901) |
| Additional Taxonomies | 106S00000X Behavior Technician |
| Enumeration Date | 2022-10-03 |
| Last Update Date | 2026-04-27 |