| NPI | 1265479562 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: TX 63253) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: MO 002675) |
| Enumeration Date | 2006-06-02 |
| Last Update Date | 2009-05-20 |