| NPI | 1609323310 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor Mental Health (Licence: TX 80261) |
| Additional Taxonomies | 222Q00000X Developmental Therapist |
| Enumeration Date | 2016-09-10 |
| Last Update Date | 2022-12-05 |