| NPI | 1295206993 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: TX 84232) |
| Additional Taxonomies | 106S00000X Behavior Technician (Licence: RBT-18-72544) |
| Enumeration Date | 2018-12-07 |
| Last Update Date | 2022-07-28 |