| NPI | 1467098566 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 101Y00000X Counselor (Licence: TX 79313)  | 
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: TX 79313)  | 
| 101YP2500X Counselor, Professional (Licence: TX 79313)  | |
| Enumeration Date | 2019-11-23 | 
| Last Update Date | 2019-11-23 |