| NPI | 1396303327 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: TX 73816) |
| Additional Taxonomies | 106S00000X Behavior Technician |
| Enumeration Date | 2019-06-04 |
| Last Update Date | 2021-06-04 |