| NPI | 1194121665 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: TX 81238) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: NM T-0170031) |
| Enumeration Date | 2014-11-11 |
| Last Update Date | 2019-02-06 |