| NPI | 1952810913 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: TX 81274) |
| Additional Taxonomies | 247200000X Technician, Other |
| 106S00000X Behavior Technician | |
| Enumeration Date | 2017-09-21 |
| Last Update Date | 2024-09-07 |