| NPI | 1356686240 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 172V00000X Community Health Worker (Licence: TX life certification) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: TX 6463) |
| Enumeration Date | 2012-12-03 |
| Last Update Date | 2012-12-03 |