| NPI | 1639181548 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor Professional (Licence: TX 66633-TX) |
| Additional Taxonomies | 101YM0800X Counselor Mental Health (Licence: FL MH6732) |
| Enumeration Date | 2006-08-12 |
| Last Update Date | 2011-10-04 |