| NPI | 1548589351 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 252Y00000X Early Intervention Provider Agency (Licence: TX 4510) |
| Additional Taxonomies | 103TA0400X Psychologist, Addiction (Substance Use Disorder) |
| 101YM0800X Counselor, Mental Health | |
| 103TB0200X Psychologist, Cognitive & Behavioral | |
| Enumeration Date | 2010-05-19 |
| Last Update Date | 2012-11-09 |