| NPI | 1245575521 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor Mental Health (Licence: TX 80105) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: TX 80105) |
| 101Y00000X Counselor (Licence: LA 6169) | |
| 101YM0800X Counselor Mental Health (Licence: LA 6169) | |
| 101YP2500X Counselor Professional (Licence: LA 6169) | |
| 222Q00000X Developmental Therapist | |
| Enumeration Date | 2012-11-28 |
| Last Update Date | 2022-09-02 |