| NPI | 1114360724 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 222Q00000X Developmental Therapist |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: UT 11742017-6004) |
| Enumeration Date | 2013-04-12 |
| Last Update Date | 2026-01-21 |