| NPI | 1619416534 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: LA 7143) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: AL 04957) |
| 101YP2500X Counselor, Professional (Licence: TX 92225) | |
| 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) (Licence: LA 7143) | |
| Enumeration Date | 2017-02-13 |
| Last Update Date | 2023-08-25 |