| NPI | 1558966127 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: TX 88343) |
| Additional Taxonomies | 106S00000X Behavior Technician |
| Enumeration Date | 2020-12-02 |
| Last Update Date | 2022-05-16 |