| NPI | 1548512817 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: TX 63503) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: TX API45233) |
| Enumeration Date | 2012-10-10 |
| Last Update Date | 2020-12-31 |