| NPI | 1003967399 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: TX 9561) | 
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: TX 9561) | 
| 103TB0200X Psychologist, Cognitive & Behavioral (Licence: TX 9561) | |
| 103TC0700X Psychologist, Clinical (Licence: TN 9561) | |
| 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: TX 9561) | |
| 103TF0000X Psychologist, Family (Licence: TX 9561) | |
| 103TF0200X Psychologist, Forensic (Licence: TX 9561) | |
| 103T00000X Psychologist (Licence: TX 9561) | |
| 103TP2701X Psychologist, Group Psychotherapy (Licence: TX 9561) | |
| Enumeration Date | 2007-01-15 | 
| Last Update Date | 2025-09-11 |