| NPI | 1356401392 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor Mental Health (Licence: TX 64244) |
| Additional Taxonomies | 101YM0800X Counselor Mental Health (Licence: OK 3615) |
| Enumeration Date | 2006-12-11 |
| Last Update Date | 2009-04-02 |