| NPI | 1790330363 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: TX 92314) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: TX 92314) |
| 101Y00000X Counselor (Licence: TX 92314) | |
| 106S00000X Behavior Technician | |
| Enumeration Date | 2019-08-09 |
| Last Update Date | 2025-12-17 |