| NPI | 1407434327 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: TX 90532) |
| Additional Taxonomies | 106S00000X Behavior Technician (Licence: TX 20-134794) |
| Enumeration Date | 2021-03-31 |
| Last Update Date | 2023-01-19 |