NPI | 1619497716 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: TX 84568) |
Additional Taxonomies | 235Z00000X Speech-Language Pathologist, (Licence: TX 37048) |
Enumeration Date | 2017-06-21 |
Last Update Date | 2022-05-23 |