| NPI | 1003054792 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: TX 6024) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: TX 99155) |
| 101Y00000X Counselor (Licence: AZ CSAT 2002C-0125) | |
| Enumeration Date | 2009-02-03 |
| Last Update Date | 2009-02-03 |