| NPI | 1659855336 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: TX 40589) |
| Additional Taxonomies | 106S00000X Behavior Technician (Licence: TX RBT-18-61610) |
| Enumeration Date | 2018-09-19 |
| Last Update Date | 2025-04-17 |