| NPI | 1982010567 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103K00000X Behavior Analyst (Licence: MI 1-16-21863) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: MI 6801096411) |
| Enumeration Date | 2014-07-03 |
| Last Update Date | 2020-03-13 |