| NPI | 1811311301 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: MI 6401014065) |
| Additional Taxonomies | 106S00000X Behavior Technician |
| Enumeration Date | 2014-02-05 |
| Last Update Date | 2019-08-29 |