| NPI | 1477099463 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor Professional (Licence: TX 76042) |
| Additional Taxonomies | 101YM0800X Counselor Mental Health (Licence: FL MH 13370) |
| Enumeration Date | 2017-01-13 |
| Last Update Date | 2017-01-13 |