| NPI | 1184288748 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 101Y00000X Counselor (Licence: TX 79281)  | 
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: TX 203145)  | 
| Enumeration Date | 2019-04-29 | 
| Last Update Date | 2019-04-29 |