| NPI | 1861709586 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: TX 77441) |
| Additional Taxonomies | 101YP2500X Counselor, Professional |
| 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities | |
| Enumeration Date | 2010-09-01 |
| Last Update Date | 2024-05-02 |