| NPI | 1053111773 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: TX 101151) |
| Additional Taxonomies | 106S00000X Behavior Technician |
| Enumeration Date | 2025-03-13 |
| Last Update Date | 2026-03-07 |