| NPI | 1053715714 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: NM 0188171) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: TX 69912) |
| Enumeration Date | 2014-10-09 |
| Last Update Date | 2017-04-11 |