| NPI | 1073284931 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: NM CTB-2026-0595) |
| Additional Taxonomies | 106S00000X Behavior Technician |
| 101YM0800X Counselor, Mental Health (Licence: NM CTB-2026-0595) | |
| Enumeration Date | 2021-09-21 |
| Last Update Date | 2026-08-12 |