| NPI | 1811403397 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker Clinical (Licence: MI 6851105793) |
| Additional Taxonomies | 1041C0700X Social Worker Clinical (Licence: MI 6801105793) |
| 106S00000X Behavior Technician | |
| Enumeration Date | 2017-12-20 |
| Last Update Date | 2021-08-11 |