| NPI | 1194057067 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: TX 19238) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: TX 96110) |
| 163W00000X Registered Nurse (Licence: TX 254643) | |
| Enumeration Date | 2010-02-03 |
| Last Update Date | 2012-06-06 |