| NPI | 1598246092 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: TX 93862) |
| Additional Taxonomies | 225200000X Physical Therapy Assistant (Licence: TX 2104098) |
| Enumeration Date | 2018-08-23 |
| Last Update Date | 2024-02-08 |