| NPI | 1790330363 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor Mental Health (Licence: TX 92314) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: TX 92314) |
| 106S00000X Behavior Technician | |
| Enumeration Date | 2019-08-09 |
| Last Update Date | 2023-12-11 |