| NPI | 1619288024 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: TX 63664) | 
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: HI 417) | 
| Enumeration Date | 2010-06-30 | 
| Last Update Date | 2023-01-10 |