| NPI | 1114702537 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: TX 117816) |
| Additional Taxonomies | 106S00000X Behavior Technician |
| Enumeration Date | 2023-08-25 |
| Last Update Date | 2026-03-31 |