| NPI | 1104002955 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 101Y00000X Counselor (Licence: TX 73353) | 
| Additional Taxonomies | 101Y00000X Counselor (Licence: UT 5747654-6004) | 
| Enumeration Date | 2008-01-10 | 
| Last Update Date | 2015-06-08 |