| NPI | 1366010563 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: TX 93039) |
| Additional Taxonomies | 106S00000X Behavior Technician (Licence: RBT-21-155377) |
| Enumeration Date | 2021-06-14 |
| Last Update Date | 2025-01-29 |