| NPI | 1417476334 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker Clinical (Licence: TX 64693) |
| Additional Taxonomies | 103TC0700X Psychologist Clinical (Licence: TX 64693) |
| Enumeration Date | 2017-09-12 |
| Last Update Date | 2021-10-25 |