| NPI | 1174326839 |
|---|---|
| Entity Type | Individual |
| Gender | N/A |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: TX 92443) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: TX 92443) |
| Enumeration Date | 2025-03-28 |
| Last Update Date | 2025-06-06 |