| NPI | 1821519299 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor Professional (Licence: MI 64010203361) |
| Additional Taxonomies | 106S00000X Behavior Technician |
| Enumeration Date | 2017-07-06 |
| Last Update Date | 2021-10-17 |