| NPI | 1164613360 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: TX 15556) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: TX 4849) |
| 101YP2500X Counselor, Professional (Licence: TX 15556) | |
| Enumeration Date | 2007-08-05 |
| Last Update Date | 2021-02-02 |