| NPI | 1992165096 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: MI 6801064295) |
| Additional Taxonomies | 103K00000X Behavior Analyst (Licence: MI 11519352) |
| Enumeration Date | 2016-03-02 |
| Last Update Date | 2016-03-02 |