| NPI | 1235244641 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: TX 11888) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: TX 11888) |
| 104100000X Social Worker (Licence: TX 11888) | |
| 106H00000X Marriage & Family Therapist (Licence: TX 1678) | |
| Enumeration Date | 2006-08-19 |
| Last Update Date | 2022-05-13 |