| NPI | 1336774314 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: UT 13350360-6010) |
| Additional Taxonomies | 106S00000X Behavior Technician |
| Enumeration Date | 2020-03-10 |
| Last Update Date | 2023-04-14 |