| NPI | 1518077619 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101Y00000X Counselor (Licence: TX 14580) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: TX 10335LPC) |
| 103T00000X Psychologist (Licence: TX 14580LCSW) | |
| Enumeration Date | 2006-08-30 |
| Last Update Date | 2019-04-15 |