| NPI | 1609555994 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 106S00000X Behavior Technician (Licence: TX RBT-23-284256) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: TX 102463) |
| Enumeration Date | 2023-07-13 |
| Last Update Date | 2026-06-09 |