| NPI | 1639473291 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: TX 97672) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: WI 4966-125) |
| Enumeration Date | 2010-12-22 |
| Last Update Date | 2026-03-17 |