| NPI | 1063084713 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: TX 112284) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: MS C8898) |
| Enumeration Date | 2021-07-13 |
| Last Update Date | 2024-01-10 |