| NPI | 1053772624 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: TX 80062) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: NM T-0179831) |
| Enumeration Date | 2016-03-10 |
| Last Update Date | 2018-10-30 |