| NPI | 1396450623 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: TX 71001) |
| Additional Taxonomies | 225800000X Recreation Therapist (Licence: OK 61750) |
| Enumeration Date | 2023-01-20 |
| Last Update Date | 2023-01-20 |