| NPI | 1972020485 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 164W00000X Licensed Practical Nurse (Licence: MI 164W00000X-NURSE-LPN) |
| Additional Taxonomies | 106S00000X Behavior Technician |
| Enumeration Date | 2017-08-25 |
| Last Update Date | 2026-07-30 |