| NPI | 1710528526 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: TX 91107) |
| Additional Taxonomies | 106S00000X Behavior Technician (Licence: TX RBT-19-85475) |
| Enumeration Date | 2019-10-02 |
| Last Update Date | 2023-04-03 |