| NPI | 1851986780 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: MI 6451023608) |
| Additional Taxonomies | 106S00000X Behavior Technician (Licence: OH RBT-21-158305) |
| Enumeration Date | 2021-03-03 |
| Last Update Date | 2024-04-24 |