| NPI | 1003172677 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: TX 67363) | 
| Additional Taxonomies | 101YM0800X Counselor, Mental Health | 
| 101Y00000X Counselor | |
| Enumeration Date | 2012-04-07 | 
| Last Update Date | 2013-08-19 |