| NPI | 1124027289 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | |
| Primary Taxonomy | 101YP2500X Counselor Professional (Licence: TX LPC 04719) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: TX LMFT 000635-41239) |
| Enumeration Date | 2005-07-20 |
| Last Update Date | 2007-07-08 |