| NPI | 1083966519 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: UT 11601167-3501) |
| Additional Taxonomies | 163WP0808X Registered Nurse, Psych/Mental Health (Licence: UT 11601167-3102) |
| 133V00000X Dietitian, Registered | |
| Enumeration Date | 2012-10-08 |
| Last Update Date | 2022-07-26 |