| NPI | 1588781793 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor Professional (Licence: TX 19069) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: TX LSOTP 98981) |
| Enumeration Date | 2007-03-23 |
| Last Update Date | 2015-07-31 |