| NPI | 1205574514 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor, Professional |
| Additional Taxonomies | 251S00000X Community/Behavioral Health (Licence: TX 65118) |
| Enumeration Date | 2022-05-25 |
| Last Update Date | 2023-09-14 |