| NPI | 1508267600 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: OR C5292)  | 
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: TX 82747)  | 
| 101YP2500X Counselor, Professional (Licence: NM CCMH0209001)  | |
| Enumeration Date | 2014-09-08 | 
| Last Update Date | 2020-03-17 |