| NPI | 1093153520 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: CO 15350) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: TX 66445) |
| Enumeration Date | 2013-06-06 |
| Last Update Date | 2019-07-16 |