| NPI | 1700454568 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: TX 100619) |
| Additional Taxonomies | 106S00000X Behavior Technician |
| Enumeration Date | 2021-06-16 |
| Last Update Date | 2025-10-31 |