| NPI | 1801120100 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker Clinical (Licence: MI 6801092203) |
| Additional Taxonomies | 101YM0800X Counselor Mental Health |
| 103K00000X Behavior Analyst | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2009-09-21 |
| Last Update Date | 2021-03-15 |