| NPI | 1629067293 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: TX 15180) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: TX 15180) |
| Enumeration Date | 2005-10-17 |
| Last Update Date | 2012-07-20 |