| NPI | 1568008258 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: UT 11077067-6004) |
| Additional Taxonomies | 322D00000X Residential Treatment Facility, Emotionally Disturbed Children (Licence: UT 11077067-6009) |
| Enumeration Date | 2019-11-18 |
| Last Update Date | 2024-01-11 |