| NPI | 1407401391 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: TX 90772) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: TX 16455) |
| 106S00000X Behavior Technician | |
| Enumeration Date | 2019-08-07 |
| Last Update Date | 2025-01-17 |