| NPI | 1235729831 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: TX 90183) |
| Additional Taxonomies | 106S00000X Behavior Technician |
| Enumeration Date | 2021-01-19 |
| Last Update Date | 2022-12-29 |