| NPI | 1346737244 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health |
| Additional Taxonomies | 320800000X Community Based Residential Treatment Facility, Mental Illness (Licence: TX 73857) |
| 261QM0850X Clinic/Center, Adult Mental Health (Licence: TX 73857) | |
| 251S00000X Community/Behavioral Health (Licence: TX 73857) | |
| 261QM0855X Clinic/Center, Adolescent and Children Mental Health (Licence: TX 73857) | |
| 251B00000X Case Management (Licence: TX 73857) | |
| Enumeration Date | 2018-04-16 |
| Last Update Date | 2025-09-11 |