| NPI | 1205115938 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: TX 69222) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: NM 0141341) |
| Enumeration Date | 2011-08-11 |
| Last Update Date | 2012-12-18 |