| NPI | 1205480712 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: TX 86436) |
| Additional Taxonomies | 106S00000X Behavior Technician (Licence: TX RBT-18-53088) |
| 101YM0800X Counselor, Mental Health (Licence: TX 86436) | |
| Enumeration Date | 2019-08-01 |
| Last Update Date | 2023-02-24 |