| NPI | 1619220498 |
|---|---|
| Former Name | JOHANNA IVETTE SANTOS RIVERA |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103K00000X Behavior Analyst (Licence: CA 1-17-28059) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: TX 66582) |
| Enumeration Date | 2012-10-18 |
| Last Update Date | 2022-11-03 |