| NPI | 1790294239 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101Y00000X Counselor (Licence: TX 65632) |
| Additional Taxonomies | 103K00000X Behavior Analyst (Licence: TX 1-12-10259) |
| Enumeration Date | 2017-09-27 |
| Last Update Date | 2017-09-27 |