| NPI | 1396122479 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: TX 78874) |
| Additional Taxonomies | 222Q00000X Developmental Therapist |
| Enumeration Date | 2015-04-28 |
| Last Update Date | 2021-05-19 |