| NPI | 1376921338 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: TX 70164) | 
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: TX 70164) | 
| Enumeration Date | 2015-05-11 | 
| Last Update Date | 2022-03-04 |