| NPI | 1760971998 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: MI 6401224113) |
| Additional Taxonomies | 106S00000X Behavior Technician |
| Enumeration Date | 2018-05-03 |
| Last Update Date | 2024-05-10 |