| NPI | 1043542582 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: TX 82501) | 
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: MD LC2718) | 
| 101YP2500X Counselor, Professional (Licence: MD LC2718) | |
| Enumeration Date | 2010-02-09 | 
| Last Update Date | 2024-11-12 |