| NPI | 1982195608 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 104100000X Social Worker (Licence: MI 6801114032) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: MI 6801114032) |
| 106S00000X Behavior Technician | |
| Enumeration Date | 2018-05-29 |
| Last Update Date | 2023-04-03 |