| NPI | 1639422769 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: TX 202724) | 
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: FL IMT1356) | 
| Enumeration Date | 2012-10-26 | 
| Last Update Date | 2021-03-10 |