| NPI | 1457690331 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: TX 64000) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| 104100000X Social Worker | |
| 1041C0700X Social Worker, Clinical (Licence: MA 120163) | |
| Enumeration Date | 2013-02-12 |
| Last Update Date | 2020-01-23 |