| NPI | 1225022940 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: SD LPC-MH2088) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: TX 66193) |
| Enumeration Date | 2005-09-08 |
| Last Update Date | 2010-04-12 |