| NPI | 1891275715 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225XP0200X Occupational Therapist, Pediatrics (Licence: MI 5201010221) |
| Additional Taxonomies | 106S00000X Behavior Technician |
| Enumeration Date | 2018-08-20 |
| Last Update Date | 2022-04-20 |