| NPI | 1104081470 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: UT 6227452-6004)  | 
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: UT 6227452-6004)  | 
| Enumeration Date | 2008-07-25 | 
| Last Update Date | 2015-04-13 |