| NPI | 1366893489 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: TX 74888) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: TX 74888) |
| 101YP2500X Counselor, Professional (Licence: TX 74888) | |
| 251S00000X Community/Behavioral Health (Licence: TX 74888) | |
| Enumeration Date | 2016-06-29 |
| Last Update Date | 2020-02-26 |