| NPI | 1063853877 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker Clinical (Licence: UT 10875612-3501) |
| Additional Taxonomies | 1041S0200X Social Worker School (Licence: UT 10875612-3501) |
| 167G00000X Licensed Psychiatric Technician | |
| Enumeration Date | 2013-07-09 |
| Last Update Date | 2022-06-07 |