| NPI | 1477957629 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker Clinical (Licence: TX 65705) |
| Additional Taxonomies | 101YM0800X Counselor Mental Health (Licence: OK 6858) |
| Enumeration Date | 2014-10-17 |
| Last Update Date | 2021-02-08 |