| NPI | 1609417708 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: TX 84083) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: TX 84083) |
| 106S00000X Behavior Technician | |
| Enumeration Date | 2019-10-01 |
| Last Update Date | 2024-11-11 |