| NPI | 1992566194 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker Clinical (Licence: MI 6851119936) |
| Additional Taxonomies | 106S00000X Behavior Technician |
| Enumeration Date | 2024-01-16 |
| Last Update Date | 2025-06-11 |