| NPI | 1104201516 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: TX 76281) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: FL IMH 11823) |
| Enumeration Date | 2015-07-27 |
| Last Update Date | 2024-05-28 |