| NPI | 1992298087 |
|---|---|
| Former Name | NICOLE MARIE OUTMAN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: MI 6351004491) |
| Additional Taxonomies | 106S00000X Behavior Technician |
| Enumeration Date | 2018-06-13 |
| Last Update Date | 2022-11-22 |