| NPI | 1255758413 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: TX 77143) |
| Additional Taxonomies | 247200000X Technician, Other |
| Enumeration Date | 2014-03-26 |
| Last Update Date | 2024-09-27 |