| NPI | 1508521006 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor Mental Health (Licence: TX 72316) |
| Additional Taxonomies | 101YM0800X Counselor Mental Health (Licence: TX 202402) |
| Enumeration Date | 2021-11-01 |
| Last Update Date | 2021-11-01 |