| NPI | 1417291253 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: TX 65321) | 
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: GA LPC009671) | 
| Enumeration Date | 2012-11-17 | 
| Last Update Date | 2022-11-14 |