| NPI | 1548006893 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: TX BCCS24270984) |
| Additional Taxonomies | 251S00000X Community/Behavioral Health (Licence: TX RBT-24-319644) |
| Enumeration Date | 2024-07-06 |
| Last Update Date | 2024-07-06 |