NPI | 1699545640 |
---|---|
Former Name | HEATHER LUZETTE JOHNSON |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 103T00000X Psychologist (Licence: UT 12205695-2504) |
Additional Taxonomies | 103K00000X Behavior Analyst (Licence: UT 12205695-2506) |
Enumeration Date | 2024-01-02 |
Last Update Date | 2024-12-08 |